NPIMap

Organization Active NPI

Nysarc Inc Nye Chapter

  • Intellectual Disabilities Intermediate Care Facility
  • Bronx, NY
National Provider Identifier
1720156854
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
NYSARC INC NYE CHAPTER
Practice address
1208 Pelham Pkwy S
Bronx, NY 10461-1029
Phone
(212) 780-2631
Fax
(212) 777-5893
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert C Goldsmith
Title
Chief Operating Officer
Phone
(212) 780-2692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

1208 Pelham Pkwy S
Bronx, NY 10461-1029

Mailing address

83 Maiden LN
11 TH Floor
New York, NY 10038-4812
Phone (212) 780-2631

Other identifiers 2

IdentifierTypeStateIssuer
6198459OtherNYNYS OMRDD OPERATING CERT
01444040MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Nysarc Inc New York City Chapter29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

1208 Pelham Pkwy S
Bronx, NY 10461

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720156854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 MAIDEN LN",
            "address_2": "11 TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384812",
            "telephone_number": "212-780-2631",
            "fax_number": "212-777-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611029",
            "telephone_number": "212-780-2631",
            "fax_number": "212-777-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYSARC INC NYE CHAPTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "212-780-2692",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS OMRDD OPERATING CERT",
            "identifier": "6198459",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01444040",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.