NPIMap

Organization Active NPI

Community Memorial Hospital

  • Critical Access Hospital
  • Hamilton, NY
National Provider Identifier
1992707608
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
2625700C Issued in NY
Legal business name
COMMUNITY MEMORIAL HOSPITAL
Practice address
150 Broad St
Hamilton, NY 13346-9575
Phone
(315) 824-6082
Fax
(315) 824-3182
NPI assigned
Aug 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Tracy Frank
Title
Cfo
Phone
(315) 824-6550

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X
General Acute Care Hospital 282N00000X 2625000H NY
Critical Access Hospital 282NC0060X 2625700C NY Primary

Addresses

Primary practice location

150 Broad St
Hamilton, NY 13346-9575

Mailing address

150 Broad St
Hamilton, NY 13346-9575
Phone (315) 824-6082

Other identifiers 1

IdentifierTypeStateIssuer
00354229MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140110000040 NY Part A Provider - Critical Access Hospital 6103805163 1 other NPI on this enrollment
Practice locations: Hamilton, NY
O20140908001055 NY Part A Provider - Critical Access Hospital 6103805163 Practice locations: Hamilton, NY

Hospital certification: CCN 331316

Legal name
COMMUNITY MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 10, 2014
Last certification
Sep 12, 2024
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 1949 in NY
Enrollment address
150 Broad St
Hamilton, NY 13346-9575

Hospital certification: CCN 33Z316

Legal name
COMMUNITY MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 1949 in NY
Enrollment address
150 Broad St
Hamilton, NY 13346-9575
Other Hospital Practice Location

Hospital certification: CCN 330249

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMUNITY MEMORIAL HOSPITAL, INC
Certification status
Terminated Other: provider status change, Dec 26, 2013
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 21, 2009
Beds
40
Ownership / control type
Private (not for profit)
Facility address
150 Broad Street
Hamilton, NY 13346

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).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Community Memorial Hospital, IncCCN 331316
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

4542 Las Posas Rd
Ste D
Camarillo, CA 93010
Phone (805) 322-8490

1636 Aviation Blvd
#202
Redondo Beach, CA 90278
Phone (310) 374-2727

4750 W Oakey Blvd
Las Vegas, NV 89102
Phone (702) 724-8877

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Joseph S Hope Individual Corporate DirectorTrustee, Board of Director May 28, 2013
Corporate DirectorTrustee, Board of Directors May 28, 2013
Susie Gustafson Individual Corporate OfficerVice Chairman, Board of Directors May 26, 2009
Corporate OfficerVice Chairman Board of Directors May 26, 2009
Patricia Caprio Individual Corporate DirectorTrustee, Board of Directors May 28, 2002
Kerri a Taylor Individual Corporate DirectorTrustee, Board of Directors Jun 23, 2010
Richard Russell Individual Corporate DirectorTrustee, Board of Directors Jan 1, 2013
Jeffery Coakley Individual Corporate OfficerPresident/Ceo Nov 4, 2020 100%
Corporate DirectorPresident/Ceo Nov 4, 2020 100%
W-2 Managing EmployeePresident/Ceo Nov 4, 2020 100%
Operational/Managerial ControlPresident/Ceo Nov 4, 2020 100%
Corporate OfficerPresident/Ceo Dec 1, 2020 100%
Corporate DirectorPresident/Ceo Dec 1, 2020 100%
W-2 Managing EmployeePresident/Ceo Dec 1, 2020 100%
Operational/Managerial ControlPresident/Ceo Dec 1, 2020 100%
Leo Tully Individual Corporate OfficerChairman, Board of Directors May 30, 2006
Jeffrey Rubenstein Individual Corporate OfficerSecretary, Board of Directors May 31, 2011
Matthew Norris Individual Corporate DirectorTrustee, Board of Directors Sep 25, 2013
Robert Tyburski Individual Corporate DirectorTrustee, Board of Directors May 28, 2013
Bradford G Wheler Individual Corporate OfficerTreasurer, Board of Directors Jul 30, 2012
William Getman Individual Corporate DirectorTrustee, Board of Directors Apr 25, 1995
Lawrence Baker Individual Corporate DirectorTrustee, Board of Directors May 30, 2006
Ivan Darius Gowan Individual Corporate DirectorTrustee, Board of Director Jun 20, 2012
Corporate DirectorTrustee, Board of Directors Jun 20, 2012
Eve Ann Shwartz Individual Corporate DirectorTrustee, Board of Directors May 28, 2012
Corporate DirectorTrustee, Board of Directors May 28, 2002
Carrie B Bova Individual Corporate DirectorExecutive Director Business Develop Oct 2, 2023
Paul J Kronenberg Individual Corporate DirectorTrustee, Board of Director Jan 1, 2013
Corporate DirectorTrustee, Board of Directors Jan 1, 2013
Gloria Lenhart Individual Corporate DirectorTrustee, Board of Directors May 28, 2013
Jason Michael Liebel Individual Corporate OfficerController Jun 17, 2022
W-2 Managing EmployeeController Jun 17, 2022
Operational/Managerial ControlController Jun 17, 2022
Judy Azud Individual W-2 Managing EmployeeExecutive Assistant Mar 1, 2016

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 44

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

View all 44

Affiliated clinicians 139

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

View all 139

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1992707608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BROAD ST",
            "city": "HAMILTON",
            "state": "NY",
            "postal_code": "133469575",
            "telephone_number": "315-824-6082",
            "fax_number": "315-824-3182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BROAD ST",
            "city": "HAMILTON",
            "state": "NY",
            "postal_code": "133469575",
            "telephone_number": "315-824-6082",
            "fax_number": "315-824-3182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "FRANK",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "315-824-6550"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "2625000H",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NY",
            "license": "2625700C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00354229",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NY

Sources for this page

Verify at the official NPI Registry.