NPIMap

Organization Active NPI

Sco Family of Services Dba Madonna Heights Service Clinic

  • Physical Disabilities Residential Treatment Facility
  • Garden City, NY
National Provider Identifier
1992801062
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
Legal business name
SCO FAMILY OF SERVICES DBA MADONNA HEIGHTS SERVICE CLINIC
Practice address
1415 Kellum PL Ste 140
Garden City, NY 11530-1604
Phone
(631) 759-1844
Fax
(516) 759-6921
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Authorized official

Name
Jaclyn Feldman
Title
Director of Revenue Cycle & Client
Phone
(516) 759-1844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X NY Primary

Addresses

Primary practice location

1415 Kellum PL Ste 140
Garden City, NY 11530-1604

Mailing address

1415 Kellum PL Ste 140
Garden City, NY 11530-1604
Phone (631) 759-1844

Other practice location 1

151 Burrs Ln
Dix Hills, NY 11746-6052
Phone (631) 213-0146

Other identifiers 6

IdentifierTypeStateIssuer
01066206MedicaidNY
01405774MedicaidNY
01857327MedicaidNY
00675530MedicaidNY
00801116MedicaidNY
02187231MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325001624 NY Part B Supplier - Clinic/Group Practice 1850283722 Receives reassigned benefits from 7 practitioners
Practice locations: Sea Cliff, NY; Dix Hills, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0953401Sco Family of Services151 Burrs Lane, Dix Hills, NY 11746Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Sco Family of Services16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

151 Burrs Ln
Dix Hills, NY 11746
Phone (631) 213-0146

1415 Kellum Pl
Ste 140
Garden City, NY 11530
Phone (516) 671-1253

Practitioners & affiliated clinicians

Practitioners 50

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

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774569600000",
    "number": "1992801062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 KELLUM PL STE 140",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301604",
            "telephone_number": "631-759-1844",
            "fax_number": "516-759-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 KELLUM PL STE 140",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301604",
            "telephone_number": "631-759-1844",
            "fax_number": "516-759-6921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Burrs Ln",
            "address_purpose": "LOCATION",
            "city": "Dix Hills",
            "state": "NY",
            "postal_code": "117466052",
            "country_code": "US",
            "telephone_number": "631-213-0146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SCO FAMILY OF SERVICES DBA MADONNA HEIGHTS SERVICE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A",
        "authorized_official_last_name": "FELDMAN",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE & CLIENT",
        "authorized_official_telephone_number": "516-759-1844"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01066206",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01405774",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01857327",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00675530",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00801116",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02187231",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.