NPIMap

Organization Active NPI

Cayuga Medical Center at Ithaca

Doing business as Cayuga Employee Pharmacy

  • Specialty Pharmacy
  • Ithaca, NY
National Provider Identifier
1730596131
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
032823 Issued in NY
Legal business name
CAYUGA MEDICAL CENTER AT ITHACA
Doing business as
Cayuga Employee Pharmacy
Practice address
201 Dates Dr Ste 109
Ithaca, NY 14850-1345
Phone
(607) 274-4385
NPI assigned
Jul 17, 2014
Last updated
Dec 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Authorized official

Name
Martin StalloneNPI 1295751782
Title
Ceo/System President
Phone
(607) 274-4189

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 032823 NY
Specialty Pharmacy 3336S0011X 032823 NY Primary

Addresses

Primary practice location

201 Dates Dr Ste 109
Ithaca, NY 14850-1345

Mailing address

201 Dates Dr Ste 109
Ithaca, NY 14850-1345

Other names 1

  • Cayuga Employee Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160304000833 NY DME Supplier - Pharmacy 7214847367 Practice locations: Ithaca, NY
O20221114001404 NY Part B Supplier - Pharmacy 7214847367 Practice locations: Ithaca, NY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Cayuga Medical Center at Ithaca201 Dates Dr, Ithaca, NY 14850-1345(607) 274-4385 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory

Locations

101 Dates Dr
Fl 2
Ithaca, NY 14850
Phone (607) 274-4985

201 Dates Dr
Ste 109
Ithaca, NY 14850
Phone (607) 274-4385

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cayuga Medical Center at IthacaIthaca, NY, CCN 33U307 Hospital Operational/Managerial Control Aug 13, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 58

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 58

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1730596131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DATES DR STE 109",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DATES DR STE 109",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501345",
            "telephone_number": "607-274-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAYUGA MEDICAL CENTER AT ITHACA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "STALLONE",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "CEO/SYSTEM PRESIDENT",
        "authorized_official_telephone_number": "607-274-4189"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032823",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NY",
            "license": "032823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cayuga Employee Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cayuga Employee Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.