NPIMap

Organization Active NPI

Upstate Cerebral Palsy, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Utica, NY
National Provider Identifier
1942361944
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
01007529 Issued in NY
Legal business name
UPSTATE CEREBRAL PALSY, INC
Practice address
6340 Trenton Rd
Utica, NY 13502-6816
Phone
(315) 724-6907
Fax
(315) 733-0791
NPI assigned
Dec 13, 2006
Last updated
Apr 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Geno Decondo
Title
Executive Director
Phone
(315) 724-6907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 01007529 NY Primary

Addresses

Primary practice location

6340 Trenton Rd
Utica, NY 13502-6816

Mailing address

125 Business Park Dr
Utica, NY 13502-6305
Phone (315) 724-6907

Other identifiers 1

IdentifierTypeStateIssuer
01007529MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
United Cerebral Palsy29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

6340 Trenton Rd
Utica, NY 13502
Phone (315) 724-6907

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1942361944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BUSINESS PARK DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026305",
            "telephone_number": "315-724-6907",
            "fax_number": "315-733-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 TRENTON RD",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026816",
            "telephone_number": "315-724-6907",
            "fax_number": "315-733-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE CEREBRAL PALSY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "DECONDO",
        "authorized_official_first_name": "GENO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "315-724-6907"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NY",
            "license": "01007529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01007529",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.