NPIMap

Organization Active NPI

State of New York

  • Intellectual Disabilities Intermediate Care Facility
  • Centereach, NY
National Provider Identifier
1821138058
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
00227848 Issued in NY
Legal business name
STATE OF NEW YORK
Practice address
206 Oxhead Rd
Centereach, NY 11720-1929
Phone
(518) 402-4333
NPI assigned
Feb 7, 2007
Organization subpart
Yes
Parent organization
STATE OF NEW YORKAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Karla Smith
Title
Director of Central Operations
Phone
(518) 402-4333

Corporate family (same tax ID) 24

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

National Provider Directory

National Provider Directory
Tax ID family
Daniel a Spengler (269 organizations share this tax ID)
Part of
Daniel a Spengler

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 00227848 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

206 Oxhead Rd
Centereach, NY 11720-1929

Mailing address

44 Holland Ave
Albany, NY 12229-0001
Phone (518) 402-4333

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
01042039MedicaidNY

Other names 1

NPPES NPI Registry
  • Long Is DC Centereach B Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 26, 2008.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1821138058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122290001",
            "telephone_number": "518-402-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 OXHEAD RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117201929",
            "telephone_number": "518-402-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW YORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF NEW YORK",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "DIRECTOR OF CENTRAL OPERATIONS",
        "authorized_official_telephone_number": "518-402-4333"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NY",
            "license": "00227848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01042039",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Is DC Centereach B",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Centereach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.