Carthage Area Hospital Inc.
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Carthage, NY
NPI 1801007364 · NPPES record last updated Dec 30, 2021
Key facts
- NPI
- 1801007364
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 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
- Organization subpart
- No
Authorized official
- Name
- Richard Duvall
- Title
- Ceo Administrator
- Phone
- (315) 519-5201
Other NPIs on the same Medicare enrollment 16
Corporate family (same tax ID) 31
Practitioners 22
-
Scott D Beeles, RPA
-
Mary B. Derosa, CRNA
-
Carly R Draper, CDN, RD
-
Trudy M Kiah, RPAC
-
Francis Y Lee, MD
-
Brandi Ann McDonald, LCSW
-
Arthur Miller, PA
-
Manuel C. Palao, MD
-
Sandeep Sirsi, MD
-
Tracy M. Tousant, LCSW
-
Elizabeth A Verno, FNP-C
-
Brandon T Wolfenden, PA-C
-
Isabelle Anne Young, FNP-P
-
Pierre B. Eugene, M.D.
-
Mojgan Javadi, DNP FNP-C
-
Gachard Jean Pierre, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Carthage Area Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 2238001H | NY | |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7731001A | Other | NY | OPERATING CERTIFICATE |
| 03000662 | Medicaid | NY | |
| 00310852 | Medicaid | NY |
Other providers in Carthage, NY
- Carthage Area Hospital Inc
- Carthage Area Hospital Inc
- Carthage Area Hospital Inc
- Carthage Area Hospital Inc.
- Carthage Area Hospital Inc.
- Carthage Area Hospital, Inc
- Carthage Area Hospital, Inc
- Carthage Area Hospital, Inc.
- Carthage Area Hospital, Inc.
- Carthage Area Hospital, Inc.
All providers in Carthage, NY · Mental Health Clinic/Center (Including Community Mental Health Center) in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.