NPIMap

Organization Active NPI

St. Luke Residential Health Care Facility, Inc.

  • Skilled Nursing Facility
  • Oswego, NY
National Provider Identifier
1659473502
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ST. LUKE RESIDENTIAL HEALTH CARE FACILITY, INC.
Doing business as
St. Luke Health Services
Practice address
299 E River Rd
Oswego, NY 13126-6400
Phone
(315) 342-3166
Fax
(315) 343-6531
NPI assigned
Sep 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terrence Gorman
Title
C.E.O.
Phone
(315) 342-3166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

299 E River Rd
Oswego, NY 13126-6400

Mailing address

299 E River Rd
Oswego, NY 13126-6400
Phone (315) 342-3166

Other identifiers 1

IdentifierTypeStateIssuer
00310201MedicaidNY

Other names 1

  • St. Luke Health Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120103000735 NY Part A Provider - Skilled Nursing Facility 0648181354 Practice locations: Oswego, NY

Skilled nursing facility certification: CCN 335746

Legal name
ST. LUKE RESIDENTIAL HEALTH CARE FACILITY, INC.
Doing business as
ST. LUKE HEALTH SERVICES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 7, 1992
Last certification
Apr 13, 2023
Beds
200
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 16, 1991 in NY
Enrollment address
299E River Rd
Oswego, NY 13126-6400
Nursing home name
ST LUKE RESIDENTIAL HEALTH CARE FACILITY INC

Care Compare: Nursing home

Medicare Care Compare
Listed as
St Luke Residential Health Care Facility IncCCN 335746 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 7, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
200123.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Michael Pollock Individual Corporate OfficerVice President Jan 1, 1992
Allison Nelson Individual Corporate DirectorBoard Member Oct 6, 2015
Michael Cullinan Individual Corporate OfficerSecretary Jan 1, 1997
Brian Caswell Individual Corporate DirectorBoard Member Jun 6, 2006
Shelly Youngs Individual W-2 Managing EmployeeAssistant Administrator Jan 1, 2021
Stephen Frawley Individual Corporate DirectorBoard Member Apr 1, 2003
Jerome Mirabito Individual Corporate OfficerPresident Jan 1, 1982
Catherine Gill Individual Corporate Officer Jan 1, 2021
W-2 Managing EmployeeAdministrator/C.E.O. Jan 1, 2021
Richard Farfaglia Individual Corporate DirectorBoard Member Feb 4, 2010

Practitioners & affiliated clinicians

Practitioners 5

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

Affiliated clinicians 3

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1659473502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 E RIVER RD",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266400",
            "telephone_number": "315-342-3166",
            "fax_number": "315-343-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 E RIVER RD",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131266400",
            "telephone_number": "315-342-3166",
            "fax_number": "315-343-6531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE RESIDENTIAL HEALTH CARE FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "315-342-3166"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00310201",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.