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Organization Active NPI

Blythedale Children's Hospital

  • Children's Rehabilitation Hospital
  • Valhalla, NY
National Provider Identifier
1679573083
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Rehabilitation HospitalTaxonomy code 283XC2000X
License
5957000H Issued in NY
Legal business name
BLYTHEDALE CHILDREN'S HOSPITAL
Practice address
95 Bradhurst Ave
Valhalla, NY 10595-1637
Phone
(914) 592-7555
Fax
(914) 592-0381
NPI assigned
Jul 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
Ms. Lisa-Marie Coppolino
Title
Director, Patient Accounts
Phone
(914) 831-2481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Rehabilitation Hospital 283XC2000X 5957000H NY Primary

Addresses

Primary practice location

95 Bradhurst Ave
Valhalla, NY 10595-1637

Mailing address

95 Bradhurst Ave
Valhalla, NY 10595-1637
Phone (914) 592-7555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110902000116 NY Part A Provider - Hospital 2961680616 Practice locations: Valhalla, NY

Hospital certification: CCN 333301

Legal name
BLYTHEDALE CHILDREN'S HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Jun 30, 1991
Last certification
Mar 31, 2023
Beds
100
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jun 23, 1948 in NY
Enrollment address
95 Bradhurst Ave
Valhalla, NY 10595-1637
Main/Primary Hospital Location
Hospital subgroups
Children’s

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Blythedale Children's HospitalCCN 333301 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Blythedale Children's Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Peter D Rittmaster Individual Corporate Director Sep 2, 2016
Timothy W Evnin Individual Corporate Director Sep 2, 2016
John E Canning Individual W-2 Managing EmployeeExecutive VP and Cfo Dec 7, 2007
Julie Eskay Eagle Individual Corporate Director Apr 9, 2024
Perry Hoffmeister Individual Corporate Director Feb 1, 2018
Nathaniel Beers Individual Corporate OfficerPresident and Ceo Nov 17, 2025 100%
W-2 Managing EmployeePresident and Ceo Nov 17, 2025

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1679573083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 BRADHURST AVE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951637",
            "telephone_number": "914-592-7555",
            "fax_number": "914-592-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 BRADHURST AVE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951637",
            "telephone_number": "914-592-7555",
            "fax_number": "914-592-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLYTHEDALE CHILDREN'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "COPPOLINO",
        "authorized_official_first_name": "LISA-MARIE",
        "authorized_official_title_or_position": "DIRECTOR, PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "914-831-2481",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "283XC2000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital, Children",
            "state": "NY",
            "license": "5957000H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.