NPIMap

Organization Active NPI

St. Mary's Healthcare

Doing business as Diabetes Prevention Program

  • General Acute Care Hospital
  • Amsterdam, NY
National Provider Identifier
1831790369
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
ST. MARY'S HEALTHCARE
Doing business as
Diabetes Prevention Program
Practice address
4950 State Highway 30
Amsterdam, NY 12010-7520
Phone
(518) 841-3717
Fax
(518) 841-3727
NPI assigned
Nov 2, 2020
Last updated
Nov 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Authorized official

Name
Jacquelyn A Greco
Title
Specialist, Provider Enrollment
Phone
(518) 770-7518

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

4950 State Highway 30
Amsterdam, NY 12010-7520

Mailing address

427 Guy Park Ave
Amsterdam, NY 12010-1064
Phone (518) 770-7518

Other names 1

  • Diabetes Prevention Program Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230322001264 NY MDPP Supplier - in-Person MDPP Supplier 7618960709 Practice locations: Amsterdam, NY

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
St Marys Hosp Fam HLTH22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

4950 State Highway 30
Amsterdam, NY 12010
Phone (518) 770-7557

NPI Registry JSON

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1831790369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 GUY PARK AVE",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120101064",
            "telephone_number": "518-770-7518",
            "fax_number": "518-770-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 STATE HIGHWAY 30",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107520",
            "telephone_number": "518-841-3717",
            "fax_number": "518-841-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "GRECO",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SPECIALIST, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "518-770-7518"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetes Prevention Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amsterdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.