NPIMap

Organization Active NPI

River Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Alexandria Bay, NY
National Provider Identifier
1821022781
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
2221700C Issued in NY
Legal business name
RIVER HOSPITAL, INC.
Practice address
4 Fuller St
Alexandria Bay, NY 13607-1316
Phone
(315) 482-1132
Fax
(315) 482-4847
NPI assigned
Jul 10, 2006
Last updated
Sep 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Emily Mastaler
Title
President and Ceo
Phone
(315) 482-2511

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 2221700C NY Primary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU

Addresses

Primary practice location

4 Fuller St
Alexandria Bay, NY 13607-1316

Mailing address

4 Fuller St
Alexandria Bay, NY 13607-1316
Phone (315) 482-2511

Other identifiers 1

IdentifierTypeStateIssuer
02392854MedicaidNY

Other names 1

  • Swing Bed Program Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://hie.healtheconnections.org/#/healthe-login Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061104000153 NY Part A Provider - Critical Access Hospital 2567372899 1 other NPI on this enrollment
Practice locations: Alexandria Bay, NY
O20061104000154 NY Part A Provider - Critical Access Hospital 2567372899 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alexandria Bay, NY

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1821022781. Details of each certification follow.

Hospital certification: CCN 33Z309

Legal name
RIVER HOSPITAL INC
Organization structure
CorporationNon-profit
Incorporated
Apr 15, 2003 in NY
Enrollment address
4 Fuller St
Alexandria Bay, NY 13607-1316

Hospital certification: CCN 331309

Legal name
RIVER HOSPITAL INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 25, 2003
Last certification
Aug 6, 2021
Beds
24
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 15, 2003 in NY
Enrollment address
4 Fuller St
Alexandria Bay, NY 13607-1316

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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.

Care Compare: Hospital

Medicare Care Compare
Listed as
River Hospital ClinicsCCN 331309 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Norman Snyder Individual Corporate Director Mar 1, 2008
Other May 1, 2001
Jolene Rosenbarker Individual W-2 Managing EmployeeHim Director Jul 20, 2021
Brooke Parmeter Individual W-2 Managing EmployeeDirector of Patient Accounts Feb 1, 2012
Kelley M Tiernan Individual Corporate OfficerChief Financial Officer Sep 1, 2020
Emily Mastaler Individual Corporate OfficerPresident and Ceo Sep 28, 2019
Corporate OfficerPresident and Chief Financial Offic Sep 28, 2019
Nellie Taylor Individual Corporate Director Jun 5, 2003
Carrie B Bova Individual W-2 Managing EmployeeDirector, Revenue Cycle Jul 1, 2015

Practitioners & affiliated clinicians

Affiliated clinicians 129

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 129

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1821022781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FULLER ST",
            "city": "ALEXANDRIA BAY",
            "state": "NY",
            "postal_code": "136071316",
            "telephone_number": "315-482-2511",
            "fax_number": "315-482-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FULLER ST",
            "city": "ALEXANDRIA BAY",
            "state": "NY",
            "postal_code": "136071316",
            "telephone_number": "315-482-1132",
            "fax_number": "315-482-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "MASTALER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "315-482-2511"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NY",
            "license": "2221700C",
            "primary": true
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02392854",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://hie.healtheconnections.org/#/healthe-login",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4 Fuller St",
            "city": "Alexandria Bay",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136071316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Swing Bed Program",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Swing Bed Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Alexandria Bay, NY

Sources for this page

Verify at the official NPI Registry.