NPIMap

Organization Active NPI

St. Johnland Nursing Center

  • Skilled Nursing Facility
  • Kings Park, NY
National Provider Identifier
1962809251
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ST. JOHNLAND NURSING CENTER
Practice address
395 Sunken Meadow Rd
Kings Park, NY 11754-1000
Phone
(631) 663-2450
Fax
(631) 663-2100
NPI assigned
Dec 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Authorized official

Name
Mr. Michael Bartolotta
Title
Chief Financial Officer
Phone
(631) 663-2450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NY Primary

Addresses

Primary practice location

395 Sunken Meadow Rd
Kings Park, NY 11754-1000

Mailing address

395 Sunken Meadow Rd
Kings Park, NY 11754-1000
Phone (631) 663-2450

Other identifiers 1

IdentifierTypeStateIssuer
1518037837MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
St Johnland Nursing Center5 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.

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1962809251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 SUNKEN MEADOW RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117541000",
            "telephone_number": "631-663-2450",
            "fax_number": "631-663-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 SUNKEN MEADOW RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117541000",
            "telephone_number": "631-663-2450",
            "fax_number": "631-663-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHNLAND NURSING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "BARTOLOTTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "631-663-2450",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518037837",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.