Active NPI
Montefiore Nyack Hospital
- Psychiatric Hospital Unit
- Nyack, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital Unit
- Legal business name
- MONTEFIORE NYACK HOSPITAL
- Practice address
- 160 N Midland Ave
Nyack, NY 10960-1912 - Phone
- (845) 348-2000
- Fax
- (845) 735-3304
- NPI assigned
- Dec 3, 2014
- Last updated
- Oct 25, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John Burke
- Title
- Vice President & Cfo
- Phone
- (845) 348-2107
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | NY | Primary |
Addresses
Primary practice location
160 N Midland Ave
Nyack, NY 10960-1912
Mailing address
160 N Midland Ave
Nyack, NY 10960-1912
Phone (845) 348-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150807014117 | NY | Part A Provider - Hospital | 2668485046 | Practice locations: Nyack, NY |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1922405190. Details of each certification follow.
Hospital certification: CCN 33S104
- Legal name
- MONTEFIORE NYACK HOSPITAL
- Doing business as
- NYACK HOSPITAL
- Organization structure
- Corporation
- Incorporated
- Jun 17, 1895 in NY
- Enrollment address
- 160 N Midland Ave
Nyack, NY 10960-1912 - Hospital subgroups
- Psychiatric
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Physician Services Nyac
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- New City, NY
- NPI 1538180559
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Adlher Rodriguez | Corporate Director | Jan 6, 2025 | |
| Mark Jacobs | Corporate Officer | Jan 1, 2021 | |
| Mark E Geller | Corporate Officer | Dec 16, 2014 | |
| W-2 Managing Employee | Jan 6, 2025 | 100% | |
| Thom Kleiner | Corporate Officer | Jan 1, 2021 |
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Psychiatry Physician
- East Meadow, NY
- NPI 1962808063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417564800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1540425600000",
"number": "1922405190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 N MIDLAND AVE",
"city": "NYACK",
"state": "NY",
"postal_code": "109601912",
"telephone_number": "845-348-2000",
"fax_number": "845-735-3304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 N MIDLAND AVE",
"city": "NYACK",
"state": "NY",
"postal_code": "109601912",
"telephone_number": "845-348-2000",
"fax_number": "845-735-3304"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONTEFIORE NYACK HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2014-12-03",
"last_updated": "2018-10-25",
"status": "A",
"authorized_official_last_name": "BURKE",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "VICE PRESIDENT & CFO",
"authorized_official_telephone_number": "845-348-2107",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "273R00000X",
"taxonomy_group": "",
"desc": "Psychiatric Unit",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nyack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.