St. James Plaza Nursing Facility, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5157308N Issued in NY

Legal business name

ST. JAMES PLAZA NURSING FACILITY, LLC

Practice address

273 Moriches Rd
Saint James, NY 11780-2117

Phone

(631) 862-8990

Fax

(631) 862-6792

NPI assigned

Nov 28, 2006

Last updated

Dec 9, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert A. Baffa, MA, NHA

Title

Administrator

Phone

(631) 862-8990

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1700952876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 MORICHES RD",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117802117",
            "telephone_number": "631-862-8990",
            "fax_number": "631-862-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 MORICHES RD",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117802117",
            "telephone_number": "631-862-8990",
            "fax_number": "631-862-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JAMES PLAZA NURSING FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "BAFFA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "631-862-8990",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5157308N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00312029",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "009536",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH INDEMNITY",
            "identifier": "522087699",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St James Medical Services PC
• St. James Dental Care, PLLC
• St. James Nursing Home
• St. James Operating LLC
• St. James Plaza
• Georgina Stampelos, DMD
• Gus Stampelos, DMD
• Kevin Stancil
• Katherine Stanton, FNP-C
• State Street Medical PLLC (Medical Trigger Point)

• Skilled Nursing Facility in Saint James, NY
• Providers in Saint James, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.