NPIMap

Organization Active NPI

North Shore University Hospital

  • Home Health Agency
  • Westbury, NY
National Provider Identifier
1861464471
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
2914601 Issued in NY
Legal business name
NORTH SHORE UNIVERSITY HOSPITAL
Practice address
972 Brush Hollow Rd
Westbury, NY 11590-1740
Phone
(516) 876-5300
Fax
(516) 876-5284
NPI assigned
Feb 7, 2006
Last updated
Dec 13, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH SHORE UNIVERSITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Authorized official

Name
Mrs. Michele Lee Cusack
Title
Senior Vice President and Cfo
Phone
(516) 321-6058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 2914601 NY Primary

Addresses

Primary practice location

972 Brush Hollow Rd
Westbury, NY 11590-1740

Mailing address

972 Brush Hollow Rd
Westbury, NY 11590-1740
Phone (516) 876-5300

Other practice location 1

540 White Plains Rd Ste 300
Tarrytown, NY 10591-5156
Phone (914) 666-7616 ext. 1127

Other practice location 2

20 Milltown Rd Ste 101
Brewster, NY 10509-4345
Phone (845) 278-4068

Other identifiers 7

IdentifierTypeStateIssuer
2951601OtherHIP
000504OtherNYEMPIRE BCBS
IC0082OtherHEALTHNET
A369809OtherOXFORD
0007380291OtherAETNA
337148OtherHORIZON HEALTHCARE
00245510MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100823000272 NY Part A Provider - Home Health Agency 5890609929 1 other NPI on this enrollment
Practice locations: New Hyde Park, NY; New York, NY; Staten Island, NY; Tarrytown, NY; Westbury, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861464471. Details of each certification follow.

Home health agency certification: CCN 337148

Legal name
NORTH SHORE UNIVERSITY HOSPITAL
Doing business as
NORTH SHORE HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 19, 1967
Last certification
Aug 26, 2011
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1990 in NY
Enrollment address
972 Brush Hollow Rd
Westbury, NY 11590-1740
HHA Branch

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: Home health agency

Medicare Care Compare
Listed as
North Shore Home Care ChhaCCN 337148 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Sep 19, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0653796North Shore University Hospital Home Care972 Brush Hollow Road, Westbury, NY 11590Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
North Shore Ekg14 organizations share this tax ID, including this one
Part of
North Shore Ekg

Other organizations with this tax ID 13

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

View all 13

Member organizations 21

Organizations listed as members of this organization in the National Provider Directory.

View all 21

Locations

20 Milltown Rd
Ste 101
Brewster, NY 10509
Phone (845) 278-4068

972 Brush Hollow Rd
Unit 3
Westbury, NY 11590

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
William L Mack Individual Corporate Director May 3, 2010
Howard B Gold Individual Corporate Director May 3, 2010
Harry E Gindi Individual Corporate Director May 3, 2010
Richard T Miller Individual Corporate OfficerEvp & Chief Bus Strategy Officer Sep 1, 2017
Jeffrey a Kraut Individual Corporate Director May 3, 2010
Robert D Rosenthal Individual Corporate OfficerTreasurer May 29, 2019
Mark L Claster Individual Corporate Director May 3, 2010
Mark J Solazzo Individual Corporate Director May 3, 2010
Richard D Goldstein Individual Corporate Director May 3, 2010
Northwell Healthcare Inc Organization, Westbury, NY Corporation, Non-profit Operational/Managerial Control Jan 1, 2015 100%
Kathleen Gallo Individual Corporate Director May 3, 2010
Donald Zucker Individual Corporate Director May 3, 2010
Barry Rubenstein Individual Corporate Director May 3, 2010
Michael a Epstein Individual Corporate OfficerChairman, Board of Trustees May 29, 2019
Mark a. Gloade Individual Corporate OfficerSVP & Deputy General Counsel May 29, 2019
Eugene S Tangney Individual Corporate Director May 3, 2010
Donna K Drummond Individual Corporate OfficerSVP & Chief Expense Officer Jan 1, 2010
Michael J Dowling Individual Corporate Director May 3, 2010
Laurence a Kraemer Individual Corporate OfficerSVP & Chief General Counsel Jan 1, 2019
Ralph a Nappi Individual Corporate OfficerExecutive Vice Chairman Jan 1, 2010
Michele L Cusack Individual Corporate OfficerSenior Vice President & Cfo Sep 12, 2017
W-2 Managing EmployeeSenior Vice President & Cfo Sep 12, 2017
Lawrence G Smith Individual Corporate Director May 3, 2010

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 28

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 28

Practitioners & affiliated clinicians

Affiliated clinicians 759

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

View all 759

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544659200000",
    "number": "1861464471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-5300",
            "fax_number": "516-876-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-876-5300",
            "fax_number": "516-876-5284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 White Plains Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tarrytown",
            "state": "NY",
            "postal_code": "105915156",
            "country_code": "US",
            "telephone_number": "914-666-7616 x1127",
            "fax_number": "914-666-9514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 Milltown Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Brewster",
            "state": "NY",
            "postal_code": "105094345",
            "country_code": "US",
            "telephone_number": "845-278-4068",
            "fax_number": "914-223-1450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH SHORE UNIVERSITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH SHORE UNIVERSITY HOSPITAL",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-12-13",
        "status": "A",
        "authorized_official_last_name": "CUSACK",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "516-321-6058",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "2914601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "2951601",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "000504",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "IC0082",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A369809",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007380291",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON HEALTHCARE",
            "identifier": "337148",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00245510",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbury, NY

Sources for this page

Verify at the official NPI Registry.