NPIMap

Organization Active NPI

Greenwich House Inc

  • Adult Psychiatric/Mental Health Registered Nurse
  • New York, NY
National Provider Identifier
1730207119
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
210573 Issued in NY
Legal business name
GREENWICH HOUSE INC
Practice address
122 West 27TH Street
6TH Floor
New York, NY 10001
Phone
(212) 691-2900
Fax
(212) 675-2985
NPI assigned
Mar 26, 2007
Last updated
Jun 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Authorized official

Name
Mr. Roy Leavitt
Title
Executive Director/Ceo
Phone
(212) 991-0003

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 211187 NY
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 210573 NY Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X 136328 NY

Addresses

Primary practice location

122 West 27TH Street
6TH Floor
New York, NY 10001

Mailing address

27 Barrow Street
New York, NY 10014-3823
Phone (212) 991-0003

Other identifiers 3

IdentifierTypeStateIssuer
01447694MedicaidNY
00244468MedicaidNY
00244477MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040304000392 NY Part B Supplier - Clinic/Group Practice 0345137170 Receives reassigned benefits from 29 practitioners
Practice locations: New York, NY
O20200414002654 NY Part B Supplier - Opioid Treatment Program (Otp) 0345137170 Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

190 Mercer St
#4
New York, NY 10012
Phone (212) 677-3400

27 Barrow St
New York, NY 10014
Phone (212) 242-4140

27 Barrow St
Fl 3
New York, NY 10014
Phone (212) 242-4140

623 Broadway
Fl 2
New York, NY 10012
Phone (212) 242-4140

Practitioners & affiliated clinicians

Practitioners 76

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 76

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1730207119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 BARROW STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100143823",
            "telephone_number": "212-991-0003",
            "fax_number": "212-366-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 WEST 27TH STREET",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-691-2900",
            "fax_number": "212-675-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWICH HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "LEAVITT",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "212-991-0003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "211187",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "210573",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NY",
            "license": "136328",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01447694",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244468",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244477",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.