NPIMap

Bon Secours Community Hospital

Organization Active NPI General Acute Care Hospital · Port Jervis, NY

NPI 1659360709 · NPPES record last updated Mar 27, 2025

Key facts

NPI
1659360709
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
Legal business name
BON SECOURS COMMUNITY HOSPITAL
Practice address
160 E Main St
Port Jervis, NY 12771-2253
Phone
(845) 858-7000
Fax
(845) 858-7415
NPI assigned
Oct 20, 2005
Organization subpart
No

Authorized official

Name
Mr. Mario Difiglia, FHFMA
Title
Vice President
Phone
(914) 493-7909

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Andrew T. Pickens IV, M.D. Emergency Medicine Physician · New Haven, CT · NPI 1235350513
    CMS ownership CORPORATE DIRECTOR · CORPORATE OFFICER · W-2 MANAGING EMPLOYEE

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 210

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 210

Medicare Care Compare: Hospital

Listed as
Bon Secours Community Hospital CCN 330135
Overall star rating
★★☆☆☆ 2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Hospital certification: CCN 330135

Legal name
BON SECOURS COMMUNITY HOSPITAL
Doing business as
WMC HEALTH NETWORK-ROCKLAND INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 18, 2024
Beds
141
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Jul 26, 1915 in NY
Enrollment address
160 E Main St
Port Jervis, NY 12771-2245
Main/Primary Hospital Location
Hospital subgroups
General

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Anthony E Costello
Individual 		Corporate Director
Vice Chair		 Jan 1, 2023
Michael N. Rosenblut
Individual 		Corporate Director
Board of Directors		 Jan 1, 2021
Andrew Pickens
Individual 		Corporate Officer
Executive Director Western Region		 Jun 26, 2025
Corporate Director
Executive Director Western Region		 Jun 26, 2025
W-2 Managing Employee
Executive Director Western Region		 Jun 26, 2025
Bon Secours Charity Health System, Inc.
Organization · Suffern, NY
Non-profit 		5% Or Greater Direct Ownership Interest Jan 1, 2000 100%
Operational/Managerial Control Jan 1, 2000 100%
Marie Yezzo
Individual 		Corporate Officer
SVP, Chief Operating Officer		 Jan 1, 2024
W-2 Managing Employee
SVP, Chief Operating Officer		 Jan 1, 2024
Mario Difiglia
Individual 		Corporate Director
Vice President		 Mar 1, 2024
Susan Gevertz
Individual 		Corporate Director
Board of Directors		 Jan 1, 2019
David Lubarsky
Individual 		Corporate Officer
President & Ceo		 Feb 17, 2025
Patrick Baker
Individual 		Corporate Director
Assistant Vice President		 Jan 1, 2023
Sandra Grannum
Individual 		Corporate Director
Board of Directors		 Jan 1, 2019
Joshua Ratner
Individual 		Corporate Director
Board of Directors		 Jan 1, 2021
Martin Rogowsky
Individual 		Corporate Officer
Board Member		 Jan 1, 2024
Tamer El-Rayess
Individual 		Corporate Director
1St Vice Chair & Treasurer-B of D		 Jan 1, 2014
Westchester Medical Center Health Network
Organization · Valhalla, NY
Corporation, Non-profit 		5% Or Greater Indirect Ownership Interest Sep 12, 2025 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040329001163 NY Part a Provider - Hospital 8527964774 Practice locations: Port Jervis, NY

National Provider Directory

Tax ID family
Mercy Hosp Phy SVS Crossr (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NY Yes

Addresses

Primary practice location

160 E Main St
Port Jervis, NY 12771-2253

Mailing address

160 E Main St
Port Jervis, NY 12771-2253
Phone (845) 858-7000

Other identifiers

IdentifierTypeStateIssuer
928114OtherNYMVP
4154304MedicaidNY
4569OtherNYWELLCARE
H384535OtherNYOXFORD
1007778760003MedicaidNY
5000031OtherNYUNITED HEALTHCARE COMPLET
00273905MedicaidNY
000000043822OtherNYGHI HMO
0004836000OtherNYAMERIHEALTH
IC0507OtherNYHEALTHNET
000000084602OtherNYTHREE RIVERS
000155OtherNYBLUE CROSS
811968OtherNYFIRST PRIORITY HEALTH
IC508OtherNYPHS
US HEALTCAREOtherNY0012335

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 27, 2025.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1659360709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E MAIN ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712253",
            "telephone_number": "845-858-7000",
            "fax_number": "845-858-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E MAIN ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712253",
            "telephone_number": "845-858-7000",
            "fax_number": "845-858-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "DIFIGLIA",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "914-493-7909",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FHFMA"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "928114",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4154304",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "4569",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "H384535",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007778760003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE COMPLET",
            "identifier": "5000031",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00273905",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "000000043822",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0004836000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "IC0507",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "000000084602",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000155",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "811968",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHS",
            "identifier": "IC508",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "0012335",
            "identifier": "US HEALTCARE",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jervis, NY

All providers in Port Jervis, NY · General Acute Care Hospital in New York

Sources for this page

Verify at the official NPI Registry.