NPIMap

Organization Active NPI

Long Island Jewish Medical Center

Doing business as Long Island Jewish Valley Stream Psychiatric Unit

  • Psychiatric Hospital Unit
  • Valley Stream, NY
National Provider Identifier
1750737565
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
LONG ISLAND JEWISH MEDICAL CENTER
Doing business as
Long Island Jewish Valley Stream Psychiatric Unit
Practice address
900 Franklin Ave
Valley Stream, NY 11580
Phone
(516) 256-6000
NPI assigned
May 11, 2016
Last updated
Sep 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Authorized official

Name
Mrs. Michele Lee Cusack
Title
Senior VP & Cfo
Phone
(516) 321-6058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary

Addresses

Primary practice location

900 Franklin Ave
Valley Stream, NY 11580

Mailing address

900 Franklin Ave
Valley Stream, NY 11580-2145

Other names 1

  • Long Island Jewish Valley Stream Psychiatric Unit Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160303000953 NY Part A Provider - Hospital 2567375421 1 other NPI on this enrollment
Practice locations: Valley Stream, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750737565. Details of each certification follow.

Hospital certification: CCN 33S19501

Legal name
LONG ISLAND JEWISH MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Oct 20, 1949 in NY
Enrollment address
900 Franklin Ave
Valley Stream, NY 11580-2145
Other Hospital Practice Location
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 8

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

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
Tax ID family
Lij Psychiatry Phych Di19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 26

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
William L Mack Individual Corporate DirectorVice Chairman Board of Trustees Apr 23, 2015
Margaret M Crotty Individual Corporate OfficerChair-Elect Jan 1, 2021
Northwell, Inc. Organization, Westbury, NY Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2024 100%
Harry E Gindi Individual Corporate OfficerAssistant Secretary Jan 1, 2021
Richard T Miller Individual Corporate OfficerEvp & Chief Bus Strategy Officer Sep 1, 2017
Jeffrey a Kraut Individual Corporate OfficerEvp Strategy Jan 1, 2021
Robert D Rosenthal Individual Corporate OfficerTreasurer Jan 1, 2021
Mark L Claster Individual Corporate DirectorVice Chairman Board of Trustees Apr 23, 2015
Mark J Solazzo Individual Corporate DirectorExecutive Vice President and Coo Apr 23, 2015
W-2 Managing EmployeeExecutive Vice President and Coo Apr 23, 2015
Richard D Goldstein Individual Corporate OfficerVice Chairman Apr 23, 2015
Northwell Healthcare Inc Organization, Westbury, NY Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jan 1, 2015 100%
Operational/Managerial Control Apr 1, 2007 100%
David L Battinelli Individual Corporate OfficerEvp Physician-in-Chief Jan 1, 2021
Kathleen Gallo Individual Corporate OfficerEvp and Chief Learning Officer Jan 1, 2021
Donald Zucker Individual Corporate DirectorSecretary Board of Trustees Apr 23, 2015
Barry Rubenstein Individual Corporate DirectorVice Chairman Board of Trustees Apr 23, 2015
Northwell Health Inc Organization, Westbury, NY Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2015 100%
Michael a Epstein Individual Corporate OfficerChair, Board of Trustees Jan 1, 2021
Mark a. Gloade Individual Corporate OfficerSVP Deputy General Counsel Jan 1, 2021
Eugene S Tangney Individual Corporate OfficerSVP Chief Bus Continuity & Crisis Jan 1, 2015
Donna K Drummond Individual Corporate OfficerSVP & Chief Expense Officer Jan 1, 2021
Joseph S Moscola Individual Corporate OfficerEvp Enterprise Services Jan 1, 2021
Michael J Dowling Individual Corporate DirectorPresident & Ceo May 23, 2005
W-2 Managing EmployeePresident & Ceo Apr 23, 2015
Operational/Managerial Control May 23, 2005
Laurence a Kraemer Individual Corporate OfficerEvp & Chief General Counsel Jan 1, 2021
Konstantine Costalas Individual Corporate OfficerSVP Managed Care Jan 1, 2021
Ralph a Nappi Individual Corporate OfficerExecutive Vice Chairman Jan 1, 2015
Michele L Cusack Individual Corporate OfficerExecutive Vice President & Cfo Sep 12, 2017
W-2 Managing EmployeeExecutive Vice President & Cfo Sep 12, 2017

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 42

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536105600000",
    "number": "1750737565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 FRANKLIN AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 FRANKLIN AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-256-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND JEWISH MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2018-09-05",
        "status": "A",
        "authorized_official_last_name": "CUSACK",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SENIOR VP & CFO",
        "authorized_official_telephone_number": "516-321-6058",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island Jewish Valley Stream Psychiatric Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Long Island Jewish Valley Stream Psychiatric Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.