NPIMap

Organization Active NPI

Cayuga Medical Center at Ithaca

  • General Acute Care Hospital
  • Ithaca, NY
National Provider Identifier
1962422733
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
5401001H Issued in NY
Legal business name
CAYUGA MEDICAL CENTER AT ITHACA
Practice address
101 Dates Dr
Ithaca, NY 14850-1342
Phone
(607) 274-4011
Fax
(607) 274-4527
NPI assigned
Jul 21, 2006
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Rebecca Gould
Title
Cfo
Phone
(607) 274-4011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 5401001H NY Primary

Addresses

Primary practice location

101 Dates Dr
Ithaca, NY 14850-1342

Mailing address

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4011

Other identifiers 15

IdentifierTypeStateIssuer
00332729MedicaidNY
284215OtherNYHEALTHLINK
7516OtherNYTOTAL CARE EMERGENCY
00011438301OtherNYUNIVERA PROVIDER NO
NY0101OtherNYJOHN DEERE
908422OtherNYHARVARD PILGRIM URG CARE
N49651OtherNYHEALTHNET CLIN LAB
5401001HOtherNYNYS PROVIDER/OPER CERT #
900266OtherNYHARVARD PILGRIM HOSP ED
7051OtherNYTOTAL CARE URG
7051OtherNYTOTAL CARE CLINIC
7300101OtherNYOPTIMUM CHOICE
925405OtherNYCONNECTICARE
365593OtherNYMVP PROVIDER NO
NY7693OtherNYHEALTHNET HOSP URG CARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121121000149 NY Part A Provider - Hospital 7214847367 Practice locations: Ithaca, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962422733. Details of each certification follow.

Hospital certification: CCN 330307

Legal name
CAYUGA MEDICAL CENTER AT ITHACA
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 9, 2022
Beds
212
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1981 in NY
Enrollment address
101 Dates Dr
Ithaca, NY 14850-1383
Other Hospital Practice Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Cayuga Medical Center at IthacaCCN 330307 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Martin Stallone Individual Corporate OfficerCeo/Ex-Officio Dec 1, 2019
Operational/Managerial ControlCeo Jan 1, 2023
Joel Malina Individual Corporate DirectorBoard of Directors Secretary Apr 1, 2018
Fred Wickham Individual Corporate DirectorBoard of Directors Member Apr 1, 2018
Paul Streeter Individual Corporate DirectorBoard Member Jan 1, 2023
Suzanne Blowers Individual Corporate OfficerSecretary Jan 1, 2023
James Brown Individual Corporate DirectorBoard Member Apr 1, 2004 7.14%
Paula Younger Individual Corporate OfficerVice Chair Jan 1, 2023
Jennifer Whittaker Individual Corporate DirectorBoard Member Jan 1, 2023
Thomas P Livigne Individual Corporate OfficerChair Jan 1, 2023
John-Paul Daniel Mead Individual Corporate DirectorBoard Member Jan 1, 2023
Yvette Conyers Individual Corporate Director Jan 1, 2023
La Jerne Terry Cornish, PH.D. Individual Corporate DirectorBoard Member Jan 1, 2023
Cris Donovan Individual Corporate DirectorBoard Member Jan 1, 2023
Gary a Koretzky Individual Corporate DirectorBoard Member Jan 1, 2023
R.Brooke Hollis Individual Corporate DirectorBoard Member Jan 1, 2023
Kenneth Clarke Individual Corporate DirectorBoard of Directors Member Apr 1, 2018
Laurie J Mante Individual Corporate DirectorBoard Member Jan 1, 2023
Eunice Nayo Individual Corporate DirectorBoard of Directors Member Apr 1, 2018
Greg Hartz Individual Corporate OfficerTreasurer Jan 1, 2023

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cayuga Medical Center at IthacaIthaca, NY, CCN 33U307 Hospital Operational/Managerial Control Aug 13, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 70

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.

View all 70

Affiliated clinicians 545

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 545

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1962422733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501342",
            "telephone_number": "607-274-4011",
            "fax_number": "607-274-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAYUGA MEDICAL CENTER AT ITHACA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "607-274-4011"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "5401001H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00332729",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "284215",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOTAL CARE EMERGENCY",
            "identifier": "7516",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA PROVIDER NO",
            "identifier": "00011438301",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "NY0101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM URG CARE",
            "identifier": "908422",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET CLIN LAB",
            "identifier": "N49651",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS PROVIDER/OPER CERT #",
            "identifier": "5401001H",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HOSP ED",
            "identifier": "900266",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOTAL CARE URG",
            "identifier": "7051",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOTAL CARE CLINIC",
            "identifier": "7051",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "7300101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "925405",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP PROVIDER NO",
            "identifier": "365593",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET HOSP URG CARE",
            "identifier": "NY7693",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.