NPIMap

Organization Active NPI

Alice Hyde Medical Center

Doing business as The University of Vermont Health Network-Alice Hyde Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Malone, NY
National Provider Identifier
1689369696
Registry record updated Feb 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
ALICE HYDE MEDICAL CENTER
Doing business as
The University of Vermont Health Network-Alice Hyde Medical Center
Practice address
133 Park St
Malone, NY 12953-1244
Phone
(518) 481-2458
Fax
(518) 481-2818
NPI assigned
Apr 6, 2023
Last updated
Feb 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2024

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

Authorized official

Name
Michelle M Lebeau
Title
President
Phone
(518) 481-2410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

133 Park St
Malone, NY 12953-1244

Mailing address

PO Box 429
Malone, NY 12953-0429
Phone (518) 481-2458

Other names 1

  • The University of Vermont Health Network-Alice Hyde Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230512000534 NY Part A Provider - Critical Access Hospital 4082525837 Receives reassigned benefits from 5 practitioners
Practice locations: Malone, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689369696. Details of each certification follow.

Hospital certification: CCN 33Z321

Legal name
ALICE HYDE MEDICAL CENTER
Doing business as
THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HYDE MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Apr 13, 1905 in NY
Enrollment address
133 Park St
Malone, NY 12953-1244
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Alice Hyde Medical Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 35

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

NameRoleSinceShare
Sivan Cotel Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2019
Nathan Monette Individual Corporate DirectorBoard Member Dec 18, 2024
Deena McCullough Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2018
Kara Odom Walker Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2021
Thomas Fitzpatrick Individual Corporate DirectorVice-Chair, Ahmc Board of Truste Sep 18, 2019
Richard J Vincent Individual Corporate OfficerNetwork Cfo Jun 2, 2014
W-2 Managing EmployeeNetwork Cfo Jun 2, 2014
Debra G Leonard Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2017
Donna J Kissane Individual Corporate DirectorAhmc Board of Trustees Dec 18, 2019
Anne M Smith Individual W-2 Managing EmployeeDirector of Revenue Cycle Jan 5, 2014
Matej Kollar Individual Corporate OfficerCfo Feb 1, 2023
W-2 Managing EmployeeCfo Feb 1, 2023
Michelle Cromwell Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2021
Robert J Laskowski Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2017
John K Rugge Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2019
Dominic Eisinger Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2021
Noma Bennett Anderson Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2022
Jason Ellis Individual Corporate DirectorAhmc Board of Trustees Dec 16, 2020
Colleen Marie Stone Individual W-2 Managing EmployeePatient Accounting Manager Jan 8, 2024
Richard L Page Individual Corporate DirectorUvmhn Board of Trustees Oct 1, 2018
Virginia Louise Hood Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2014
Joshua L Frank Individual Corporate DirectorAhmc Board of Trustees Mar 24, 2022
Tom Golonka Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2020
Michelle M Lebeau Individual Corporate OfficerPresident Apr 2, 2018
W-2 Managing EmployeePresident Apr 2, 2018
The University of Vermont Health Network Inc. Organization, Burlington, VT Corporation, Management services company, Holding company, Non-profit 5% Or Greater Direct Ownership Interest Oct 7, 2015 100%
Victoria Z Duley Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2020
Susan N Vogelzang Individual W-2 Managing EmployeeRevenue Cycle Manager Aug 13, 2020
Kerin Elizabeth Stackpole Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2016
Barbara Montour Individual Corporate DirectorAhmc Board of Trustees Jun 24, 2021
Craig W Richards Individual Corporate Director Mar 24, 2022
Hannah Busman Individual Corporate DirectorBoard Member Dec 18, 2024
Elizabeth Vicencio Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2022
Mary Alice Stickney Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2015
John James Dwyer Individual Corporate DirectorUvmhn Board of Trustees Jan 1, 2020
Robert G Main Individual Corporate DirectorChair, Ahmc Board of Trustees Apr 20, 2016
Kevin J Hart Individual Corporate DirectorAhmc and Uvmhn Board of Trustee Feb 24, 2016
Robert Ramsey Herrington Individual Corporate DirectorBoard Member Dec 18, 2024

Owners & managing parties with NPI records 6

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 4

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": "1680739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708128000000",
    "number": "1689369696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 429",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129530429",
            "telephone_number": "518-481-2458",
            "fax_number": "518-481-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 PARK ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531244",
            "telephone_number": "518-481-2458",
            "fax_number": "518-481-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICE HYDE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-06",
        "last_updated": "2024-02-17",
        "certification_date": "2024-02-17",
        "status": "A",
        "authorized_official_last_name": "LEBEAU",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-481-2410"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1'",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The University of Vermont Health Network-Alice Hyde Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The University of Vermont Health Network-Alice Hyde Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Malone, NY

Sources for this page

Verify at the official NPI Registry.