NPIMap

Organization Active NPI

Adirondack Medical Center

  • Psychiatric Hospital Unit
  • Saranac Lake, NY
National Provider Identifier
1831226273
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
33S079 Issued in NY
Legal business name
ADIRONDACK MEDICAL CENTER
Practice address
2233 State Route 86
Colby Center
Saranac Lake, NY 12983-5644
Phone
(518) 897-2351
Fax
(518) 897-2868
NPI assigned
Feb 27, 2007
Last updated
Oct 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Susan S Stratford, CPC
Title
PFS Supervisor
Phone
(518) 897-2636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 33S079 NY Primary

Addresses

Primary practice location

2233 State Route 86
Colby Center
Saranac Lake, NY 12983-5644

Mailing address

2233 State Route 86
Colby Center
Saranac Lake, NY 12983-5644
Phone (518) 897-2351

Other identifiers 1

IdentifierTypeStateIssuer
00363213MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110808000274 NY Part A Provider - Hospital 9638081284 Practice locations: Saranac Lake, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831226273. Details of each certification follow.

Hospital certification: CCN 33S079

Legal name
ADIRONDACK MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Dec 21, 1992 in NY
Enrollment address
2233 State Route 86
Saranac Lake, NY 12983-5644
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Adirondack Medical Cent7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Charles Carroll Individual Corporate DirectorBoard Member Jan 1, 2017
Charles Glanville Individual Corporate OfficerCfo Feb 1, 2017
Jeannie Cross Individual Corporate DirectorBoard Member Jan 1, 2017
Cheryl Maid Individual Corporate DirectorBoard Member Jan 1, 2017
Adele Lyon Individual W-2 Managing EmployeeAd; Jan 1, 2025
F Raymond Agnew Individual Corporate DirectorBoard Member Jan 1, 2017
Julie Wood Individual Corporate DirectorDirector of PFS Jan 1, 2025
Patti Hammond Individual Corporate OfficerCoo Feb 1, 2017
Operational/Managerial ControlCoo Feb 1, 2017
Joanne a Bruce Individual W-2 Managing EmployeeMedical Billing Coordinator Oct 18, 1993

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1831226273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 STATE ROUTE 86",
            "address_2": "COLBY CENTER",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835644",
            "telephone_number": "518-897-2351",
            "fax_number": "518-897-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 STATE ROUTE 86",
            "address_2": "COLBY CENTER",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835644",
            "telephone_number": "518-897-2351",
            "fax_number": "518-897-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADIRONDACK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "STRATFORD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PFS SUPERVISOR",
        "authorized_official_telephone_number": "518-897-2636",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NY",
            "license": "33S079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00363213",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saranac Lake, NY

Sources for this page

Verify at the official NPI Registry.