NPIMap

Organization Active NPI

Coram Healthcare Corporation of Greater New York

Doing business as Coram CVS/specialty Infusion Services

  • Home Infusion Agency
  • Cohoes, NY
National Provider Identifier
1891071098
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
Legal business name
CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK
Doing business as
Coram CVS/specialty Infusion Services
Practice address
55 Mohawk St
Cohoes, NY 12047-2629
Phone
(518) 689-2900
Fax
(518) 689-2901
NPI assigned
Nov 1, 2011
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CORAM HEALTHCARE CORPORATION OF GREATER NEW YORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Tricia Lacavich
Title
Presadent
Phone
(314) 306-3255

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Home Infusion Agency 251F00000X Primary

Addresses

Primary practice location

55 Mohawk St
Cohoes, NY 12047-2629

Mailing address

PO Box 809160
Chicago, IL 60680-9160
Phone (303) 672-8631

Other identifiers 2

IdentifierTypeStateIssuer
031091OtherNYPHARMACY PERMIT
5804554OtherNCPDP

Other names 1

  • Coram CVS/specialty Infusion Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

National Provider Directory

National Provider Directory
Part of
Coram Healthcare Corporation of Greater New York

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4823 55th Ave
Maspeth, NY 11378
Phone (855) 348-2985

45 S Service Rd
Plainview, NY 11803
Phone (516) 753-5330

2949 Erie Blvd E
Syracuse, NY 13224
Phone (315) 251-1036

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1891071098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809160",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606809160",
            "telephone_number": "303-672-8631",
            "fax_number": "303-298-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MOHAWK ST",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120472629",
            "telephone_number": "518-689-2900",
            "fax_number": "518-689-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK",
        "enumeration_date": "2011-11-01",
        "last_updated": "2023-03-07",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "LACAVICH",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "PRESADENT",
        "authorized_official_telephone_number": "314-306-3255"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT",
            "identifier": "031091",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5804554",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Coram CVS/specialty Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coram CVS/specialty Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cohoes, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.