NPIMap

Organization Active NPI

Staten Island University Hospital

  • Psychiatric Hospital Unit
  • Staten Island, NY
National Provider Identifier
1912925199
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
7004003H Issued in NY
Legal business name
STATEN ISLAND UNIVERSITY HOSPITAL
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-4502
Fax
(718) 226-4875
NPI assigned
Jul 17, 2006
Organization subpart
Yes
Parent organization
STATEN ISLAND UNIVERSITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Ms. Michele Cusack
Title
SVP and Cfo
Phone
(516) 321-6058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 7004003H NY Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-4502

Other identifiers 3

IdentifierTypeStateIssuer
000881OtherNYBLUE CROSS PSYCH
00244202MedicaidNY
330860OtherNJBLUE CROSS PSYCH

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071017000762 NY Part A Provider - Hospital 8628985504 Practice locations: Staten Island, NY

Hospital certification: CCN 33S160

Legal name
STATEN ISLAND UNIVERSITY HOSPITAL
Doing business as
STATEN ISLAND UNIVERSITY HOSPITAL PRINCE'S BAY
Organization structure
CorporationNon-profit
Incorporated
Apr 11, 1989 in NY
Enrollment address
375 Seguine Ave
Staten Island, NY 10309-3932
Hospital Psychiatric Unit
Hospital subgroups
General, Acute care, Psychiatric unit, Rehabilitation unit

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
Staten Island University Hospital - Early Intervention21 organizations share this tax ID, including this one
Part of
Staten Island University Hospital - Early Intervention

Other organizations with this tax ID 20

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

View all 20

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 26

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 OfficerVice Chariman Jan 1, 2015
Margaret M Crotty Individual Corporate Officer Jan 1, 2025
Northwell, Inc. Organization, Westbury, NY Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2024 100%
Harry E Gindi Individual Corporate Officer Jan 1, 2025
Jeffrey a Kraut Individual Corporate Officer Jan 1, 2025
Robert D Rosenthal Individual Corporate Officer Jan 1, 2025
Mark L Claster Individual Corporate OfficerChairman of the Board of Trustees Jan 1, 2015
Brian Lally Individual Corporate Officer Jan 1, 2025
Mark J Solazzo Individual Corporate Officer Jan 1, 2025
William Erik Schachtel Individual W-2 Managing Employee Jan 1, 2026
Richard D Goldstein Individual Corporate OfficerImmediate Past Chairman Jan 1, 2015
Northwell Healthcare Inc Organization, Westbury, NY Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jan 1, 2015 100%
Operational/Managerial Control Mar 1, 1994
David L Battinelli Individual Corporate Officer Jan 1, 2025
Donald Zucker Individual Corporate OfficerSecretary Jan 1, 2007
Barry Rubenstein Individual Corporate OfficerVice Chairman Jan 1, 2015
Northwell Health Inc Organization, Westbury, NY Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2015 100%
Michael a Epstein Individual Corporate Officer Jan 1, 2025
Mark a. Gloade Individual Corporate Officer Jan 1, 2025
John K D'Angelo Individual Corporate Officer Jan 1, 2025
Donna K Drummond Individual Corporate Officer Jan 1, 2025
Michael J Dowling Individual Corporate Officer Jan 1, 2009
Laurence a Kraemer Individual Corporate Officer Jan 1, 2025
Konstantine Costalas Individual Corporate Officer Jan 1, 2025
Ralph a Nappi Individual Corporate OfficerExecutive Vice Chariman Jan 1, 2015
Kevin Beiner Individual Corporate Officer Jan 1, 2025
Michele L Cusack Individual Corporate Officer Sep 12, 2017
Corporate Director Sep 12, 2017
W-2 Managing EmployeeSenior Vice President & Cfo Sep 12, 2017

Owners & managing parties with NPI records 3

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

Facilities with the same owner 42

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

View all 42

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1912925199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-4502",
            "fax_number": "718-226-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-4502",
            "fax_number": "718-226-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND UNIVERSITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATEN ISLAND UNIVERSITY HOSPITAL",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "CUSACK",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "SVP AND CFO",
        "authorized_official_telephone_number": "516-321-6058",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NY",
            "license": "7004003H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PSYCH",
            "identifier": "000881",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244202",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PSYCH",
            "identifier": "330860",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.