NPIMap

Organization Active NPI

Carthage Area Hospital Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carthage, NY
National Provider Identifier
1801007364
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CARTHAGE AREA HOSPITAL INC.
Practice address
3 Bridge St
Carthage, NY 13619-1333
Phone
(315) 493-3300
Fax
(315) 493-0105
NPI assigned
May 25, 2007
Last updated
Dec 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Authorized official

Name
Richard Duvall
Title
Ceo Administrator
Phone
(315) 519-5201

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2238001H NY
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3 Bridge St
Carthage, NY 13619-1333

Mailing address

1001 West St
Carthage, NY 13619-9703
Phone (315) 519-5724

Other identifiers 3

IdentifierTypeStateIssuer
03000662MedicaidNY
00310852MedicaidNY
7731001AOtherNYOPERATING CERTIFICATE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000856 NY Part B Supplier - Clinic/Group Practice 9931010485 Receives reassigned benefits from 250 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waddington, NY; Philadelphia, NY; Ogdensburg, NY; Heuvelton, NY; Hammond, NY; Carthage, NY; Canton, NY; Madrid, NY

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Carthage Area Hosp32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Locations

214 King St
Ste A
Ogdensburg, NY 13669
Phone (315) 394-7542

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640822400000",
    "number": "1801007364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 WEST ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136199703",
            "telephone_number": "315-519-5724",
            "fax_number": "315-493-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BRIDGE ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191333",
            "telephone_number": "315-493-3300",
            "fax_number": "315-493-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTHAGE AREA HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "DUVALL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO ADMINISTRATOR",
        "authorized_official_telephone_number": "315-519-5201"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "2238001H",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03000662",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00310852",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING CERTIFICATE",
            "identifier": "7731001A",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.