NPIMap

Organization Active NPI

Upstate Cerebral Palsy, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Rome, NY
National Provider Identifier
1871654863
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
02683338 Issued in NY
Legal business name
UPSTATE CEREBRAL PALSY, INC
Practice address
120 Brookley Road
CRP #5
Rome, NY 13341
Phone
(315) 533-1166
Fax
(315) 533-1165
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Geno Decondo
Title
Executive Director
Phone
(315) 927-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 02683338 NY Primary

Addresses

Primary practice location

120 Brookley Road
CRP #5
Rome, NY 13341

Mailing address

125 Business Park Dr
Utica, NY 13502-6305
Phone (315) 724-6907

Other identifiers 1

IdentifierTypeStateIssuer
02683338MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Upstate Cerebral Palsy Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1871654863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BUSINESS PARK DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026305",
            "telephone_number": "315-724-6907",
            "fax_number": "315-733-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BROOKLEY ROAD",
            "address_2": "CRP #5",
            "city": "ROME",
            "state": "NY",
            "postal_code": "13341",
            "telephone_number": "315-533-1166",
            "fax_number": "315-533-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE CEREBRAL PALSY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "DECONDO",
        "authorized_official_first_name": "GENO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "315-927-2117"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NY",
            "license": "02683338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02683338",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.