NPIMap

Organization Active NPI

United Cerebral Palsy Association of Nassau County, Inc.

  • Clinic/Center
  • Roosevelt, NY
National Provider Identifier
1720009715
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
2950200R Issued in NY
Legal business name
UNITED CEREBRAL PALSY ASSOCIATION OF NASSAU COUNTY, INC.
Practice address
380 Washington Ave
Roosevelt, NY 11575-1845
Phone
(516) 378-2000
Fax
(516) 377-2066
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Authorized official

Name
Ellen Naidus
Title
Clinic Director
Phone
(516) 378-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 280208997798 NY
Clinic/Center 261Q00000X 2950200R NY Primary

Addresses

Primary practice location

380 Washington Ave
Roosevelt, NY 11575-1845

Mailing address

380 Washington Ave
Roosevelt, NY 11575-1899
Phone (516) 378-2000

Other identifiers 3

IdentifierTypeStateIssuer
00277207MedicaidNY
0030639OtherNYGHI PROVIDER NUMBER
CJ9047OtherNYRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310001199 NY Part B Supplier - Clinic/Group Practice 1153210042 Receives reassigned benefits from 32 practitioners
Practice locations: Roosevelt, NY

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

380 Washington Ave
Roosevelt, NY 11575
Phone (516) 375-2000

Practitioners & affiliated clinicians

Practitioners 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1720009715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 WASHINGTON AVE",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751899",
            "telephone_number": "516-378-2000",
            "fax_number": "516-377-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 WASHINGTON AVE",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751845",
            "telephone_number": "516-378-2000",
            "fax_number": "516-377-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CEREBRAL PALSY ASSOCIATION OF NASSAU COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "NAIDUS",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "516-378-2000"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "280208997798",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "2950200R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00277207",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PROVIDER NUMBER",
            "identifier": "0030639",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ9047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.