Canton-Potsdam Hospital
Organization Active NPI Emergency Medicine Physician · Potsdam, NY
NPI 1801229216 · NPPES record last updated Aug 21, 2013
Key facts
- NPI
- 1801229216
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- CANTON-POTSDAM HOSPITAL
- Practice address
- 50 Leroy St
Potsdam, NY 13676-1786 - Phone
- (315) 261-5910
- Fax
- (315) 261-6410
- NPI assigned
- Aug 21, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- CANTON-POTSDAM HOSPITAL
Authorized official
- Name
- Mr. Richard D Jacobs
- Title
- Cfo
- Phone
- (315) 261-5100
Other NPIs on the same Medicare enrollment 2
Practitioners 1
-
Jason Lorenc, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040519000761 | NY | Part B Supplier - Clinic/Group Practice | 6204827280 |
Receives reassigned benefits from 459 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Syracuse, NY; Rochester, NY; Potsdam, NY; Norfolk, NY; Massena, NY; Governed, NY; Canton, NY; Brasher Falls, NY |
National Provider Directory
- Part of
- Canton-Potsdam Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
50 Leroy St
Potsdam, NY 13676-1786
Mailing address
1116 Arsenal Street
Suite 504
Watertown, NY 13601-6120
Phone (315) 782-2620
Other names
- CPH Emergency Physicians
Other providers in Potsdam, NY
- Victor Michael Caamano
- Katherine McCarney Calcagno
- Canton Potsdam Hospital
- Canton-Potsdam Hospital
- Canton-Potsdam Hospital
- Canton-Potsdam Hospital
- Elizabeth Carey
- Christine Mary Carr
- Robert Thomas Carr
- John E Carvill
All providers in Potsdam, NY · Emergency Medicine Physician 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 Aug 21, 2013. 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.