NPIMap

Organization Active NPI

Columbia Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Copake, NY
National Provider Identifier
1720333479
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
1001000H Issued in NY
Legal business name
COLUMBIA MEMORIAL HOSPITAL
Practice address
283 Mountain View Rd
Copake, NY 12516-1201
Phone
(518) 329-3900
Fax
(518) 329-1040
NPI assigned
Jul 18, 2012
Last updated
May 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Authorized official

Name
Mr. Bryan Mahoney
Title
Chief Financial Officer
Phone
(518) 828-8249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 1001000H NY Primary

Addresses

Primary practice location

283 Mountain View Rd
Copake, NY 12516-1201

Mailing address

PO Box 2000
Hudson, NY 12534-2000
Phone (518) 828-8051

Other identifiers 1

IdentifierTypeStateIssuer
W79533OtherNYMEDICARE GROUP

Other names 1

  • Callan Family Care Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040409000109 NY Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 252 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Catskill, NY; Valatie, NY; Hudson, NY; Copake, NY; Chatham, NY; Albany, NY; Cairo, NY; Hensonville, NY

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462320000000",
    "number": "1720333479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342000",
            "telephone_number": "518-828-8051",
            "fax_number": "518-697-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 MOUNTAIN VIEW RD",
            "city": "COPAKE",
            "state": "NY",
            "postal_code": "125161201",
            "telephone_number": "518-329-3900",
            "fax_number": "518-329-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2016-05-04",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "518-828-8249",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NY",
            "license": "1001000H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "W79533",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Callan Family Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Copake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.