NPIMap

Organization Active NPI

Schuyler Hospital Inc

  • Rural Health Clinic/Center
  • Ovid, NY
National Provider Identifier
1902430689
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SCHUYLER HOSPITAL INC
Practice address
2138 W Seneca St
Ovid, NY 14521-9701
Phone
(607) 869-2514
Fax
(607) 869-3001
NPI assigned
Mar 3, 2020
Last updated
Apr 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Authorized official

Name
Malia Popovich, RHIT, CCS
Title
Physician Billing Supervisor
Phone
(607) 535-8639

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

2138 W Seneca St
Ovid, NY 14521-9701

Mailing address

220 Steuben St
Montour Falls, NY 14865-9709
Phone (607) 535-8639

Other names 1

  • Ovid Rural Health Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200427000892 NY Part A Provider - Rural Health Clinic 3577548262 Practice locations: Ovid, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902430689. Details of each certification follow.

Rural health clinic certification: CCN 338500

Legal name
SCHUYLER HOSPITAL INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 21, 2022
Last certification
Jan 17, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 22, 1920 in NY
Enrollment address
2138 W Seneca St
Ovid, NY 14521-9701
Related CCNs
331313

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Schuyler Hosp Primary C5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

2138 W Seneca St
Ovid, NY 14521
Phone (607) 869-2541

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Larry F Baum Individual Corporate Director May 1, 2016
Jerry Mickelson Individual Corporate Director May 1, 2016
John Lambert Individual Corporate Director May 1, 2016
Martin Stallone Individual Corporate DirectorPresident and Ceo CHS Bod Sep 1, 2019
Carl Sgrecci Individual Corporate Director May 1, 2016
Joel Malina Individual Corporate Director May 1, 2016
Fred Wickham Individual Corporate Director May 1, 2016
Deborah Alice Bailey Individual Corporate OfficerExec. Director of Patient Care Serv Jun 18, 1990
Suzanne Blowers Individual Corporate Director May 1, 2016
James Brown Individual Corporate Director May 1, 2016
Paula Younger Individual Corporate Director May 1, 2016
Thomas P Livigne Individual Corporate DirectorSecretary May 1, 2016
Kristin Hall Individual Operational/Managerial ControlClinical Ops Manager Jan 2, 2017
Gary Ferguson Individual Corporate Director May 1, 2016
Jackie Collins Individual Operational/Managerial ControlPatient Experiance Manager & Clinic Feb 4, 2004
Matthew Rouff Individual Corporate OfficerExec. Director Outpatient and Suppo Jul 13, 2015
Benjamin J Saks Individual Corporate Director May 1, 2016
Kenneth Clarke Individual Corporate Director May 1, 2016
Rebecca Gould Individual Corporate OfficerPresident and Cfo Feb 7, 2020
Eunice Nayo Individual Corporate Director May 1, 2016
Greg Hartz Individual Corporate DirectorTreasurer May 1, 2016

Owners & managing parties with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1902430689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STEUBEN ST",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659709",
            "telephone_number": "607-535-8639",
            "fax_number": "607-535-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 W SENECA ST",
            "city": "OVID",
            "state": "NY",
            "postal_code": "145219701",
            "telephone_number": "607-869-2514",
            "fax_number": "607-869-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHUYLER HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "POPOVICH",
        "authorized_official_first_name": "MALIA",
        "authorized_official_title_or_position": "PHYSICIAN BILLING SUPERVISOR",
        "authorized_official_telephone_number": "607-535-8639",
        "authorized_official_credential": "RHIT, CCS"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ovid Rural Health Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Ovid Rural Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ovid, NY

Sources for this page

Verify at the official NPI Registry.