NPIMap

Organization Active NPI

Federation of Organizations for the Ny State Mentally Disabled Inc

  • Adult Mental Health Clinic/Center
  • Patchogue, NY
National Provider Identifier
1902068240
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
01303882 Issued in NY
Legal business name
FEDERATION OF ORGANIZATIONS FOR THE NY STATE MENTALLY DISABLED INC
Practice address
456 Waverly Ave
Patchogue, NY 11772-1586
Phone
(631) 447-6460
Fax
(631) 289-7098
NPI assigned
Jun 27, 2008
Last updated
Apr 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Mr. Stephen McCarthy, CPA
Title
Chief Financial Officer
Phone
(631) 669-5355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 01303882 NY Primary

Addresses

Primary practice location

456 Waverly Ave
Patchogue, NY 11772-1586

Mailing address

1 Farmingdale Rd
West Babylon, NY 11704-6545
Phone (631) 669-5355

Other identifiers 1

IdentifierTypeStateIssuer
02716952MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050721001040 NY Part B Supplier - Clinic/Group Practice 6800823782 Receives reassigned benefits from 25 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wyandanch, NY; West Babylon, NY; Patchogue, NY; Copiague, NY; Brooklyn, NY

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Federation of Organizations30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1902068240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FARMINGDALE RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117046545",
            "telephone_number": "631-669-5355",
            "fax_number": "631-669-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 WAVERLY AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721586",
            "telephone_number": "631-447-6460",
            "fax_number": "631-289-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERATION OF ORGANIZATIONS FOR THE NY STATE MENTALLY DISABLED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "631-669-5355",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "01303882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02716952",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.