NPIMap

Organization Active NPI

The Bridge, Inc.

  • Community/Behavioral Health Agency
  • New York, NY
National Provider Identifier
1831269315
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
THE BRIDGE, INC.
Practice address
248 W 108TH St
6TH Floor
New York, NY 10025-2956
Phone
(212) 663-3000
Fax
(212) 280-1793
NPI assigned
Nov 9, 2006
Last updated
May 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Authorized official

Name
Ms. Susan Wiviott, J.D.
Title
Executive Director
Phone
(212) 663-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

248 W 108TH St
6TH Floor
New York, NY 10025-2956

Mailing address

248 W 108TH St
6TH Floor
New York, NY 10025-2956
Phone (212) 663-3000

Other identifiers 3

IdentifierTypeStateIssuer
00273267MedicaidNY
01305059MedicaidNY
02187240MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060106000770 NY Part B Supplier - Clinic/Group Practice 3476576273 Receives reassigned benefits from 25 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory
Tax ID family
The Bridge4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1767 Park Ave
New York, NY 10035
Phone (212) 289-8900

1795 Lexington Ave
New York, NY 10029
Phone (212) 289-1788

248 W 108th St
Fl 6
New York, NY 10025

290 Lenox Ave
New York, NY 10027
Phone (646) 574-9632

290 Lenox Ave
Fl 2
New York, NY 10027
Phone (212) 289-1788

290 Lenox Ave
Fl 3
New York, NY 10027
Phone (870) 476-6003

551 W 125th St
New York, NY 10027
Phone (212) 289-1788

Practitioners & affiliated clinicians

Practitioners 121

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.

View all 121

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1831269315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 W 108TH ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252956",
            "telephone_number": "212-663-3000",
            "fax_number": "212-280-1793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 W 108TH ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252956",
            "telephone_number": "212-663-3000",
            "fax_number": "212-280-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRIDGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "WIVIOTT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "212-663-3000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00273267",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01305059",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02187240",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.