NPIMap

Organization Active NPI

Adults and Children With Learning and Developmental Disabilities, Inc.

  • Developmental Disabilities Clinic/Center
  • Bethpage, NY
National Provider Identifier
1730194408
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
2950208R Issued in NY
Legal business name
ADULTS AND CHILDREN WITH LEARNING AND DEVELOPMENTAL DISABILITIES, INC.
Practice address
807 S Oyster Bay Rd
Bethpage, NY 11714-1030
Phone
(516) 822-0028
NPI assigned
Jul 30, 2006
Last updated
Jun 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Mr. Mark Crean
Title
Director of Health Services
Phone
(516) 822-0028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X 2950208R NY Primary

Addresses

Primary practice location

807 S Oyster Bay Rd
Bethpage, NY 11714-1030

Mailing address

807 S Oyster Bay Rd
Bethpage, NY 11714-1030
Phone (516) 822-0028

Other identifiers 1

IdentifierTypeStateIssuer
01376021MedicaidNY

Other names 1

  • ACLD Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000377 NY Part B Supplier - Clinic/Group Practice 8921997172 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Bethpage, NY; Hauppauge, NY

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1730194408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 S OYSTER BAY RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117141030",
            "telephone_number": "516-822-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S OYSTER BAY RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117141030",
            "telephone_number": "516-822-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULTS AND CHILDREN WITH LEARNING AND DEVELOPMENTAL DISABILITIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "CREAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH SERVICES",
        "authorized_official_telephone_number": "516-822-0028",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NY",
            "license": "2950208R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01376021",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACLD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bethpage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.