PEDERSON-KRAG (NPI# 1104253772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104253772 |
| Entity Type | Organization |
| Organization Name | PEDERSON-KRAG |
| Practice Address |
77 Radcliffe Ave. Farmingdale NY 11735 |
| Mailing Address |
77 Radcliffe Ave Farmingdale NY 11735-5222 |
| Practice Telephone | 5163018283 |
| Mailing Telephone | 5163018283 |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2013-09-27 |
| Authorized Official Name | JEREMY TONER (SOCIAL WORKER) |
| Authorized Official Telephone | 5163018289 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PEDERSON-KRAG CENTER, INC. | 1425 Rxr Plaza, Uniondale, New York 11556 |
| Street Address |
77 RADCLIFFE AVE. |
| City | FARMINGDALE |
| State | NY |
| Zip Code | 11735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073151197 | Center Island Massage PC | Massage Therapist | 34 Hempstead Turnpike, Suite E, Farmingdale, NY 11735 | 2019-12-19 |
| 1447736434 | Melanie Clampitt | Occupational Therapy Assistant | 158 Sunset Ave, Farmingdale, NY 11735 | 2018-07-13 |
| 1841789120 | I-ting Lin | Acupuncturist | 376 Fulton St. The Phoenix Eastern Medicine Center, Farmingdale, NY 11735 | 2018-05-02 |
| 1447767371 | Nashon Clark | Social Worker | 565 Broadhollow Rd Ste 6e, Farmingdale, NY 11735 | 2017-12-31 |
| 1336669639 | Robby Harris | Psychologist | 31 Lincoln Street, Farmingdale, NY 11735 | 2017-06-27 |
| 1265961544 | Stacey Gouzos | Behavior Technician | 29 Bernard Street, Farmingdale, NY 11735 | 2017-06-08 |
| 1962856450 | Integrated Medical Interventional Diagnostics PC | Registered Nurse | 1111 Broad Hollow Rd 110 Suite 114, Farmingdale, NY 11735 | 2016-04-20 |
| 1528433604 | Robert Gerard Jr. | Peer Specialist | 142-02 20th Aveune, Rosedale, NY 11735 | 2015-12-01 |
| 1750750329 | Glenda Lopez | Case Manager/Care Coordinator | 539 Broad Hollow Rd, Suite 202, Farmingdale, NY 11735 | 2015-09-24 |
| 1366849911 | Jeffrey Rosa | Counselor | 500 Bi-country Blvd, Suite 114, Farmingdale, NY 11735 | 2014-11-25 |
| Find all providers in zip 11735 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063861078 | Union Community Health Center | Psychiatric Unit | 260 Eats 188th Street, Bronx, NY 10458-5302 | 2016-06-09 |
| 1033579446 | Pura Garcia-serrablo | Psychiatric Unit | 21006 42nd Ave, Apt. 1e, Bayside, NY 11361-2771 | 2016-02-26 |
| 1376916635 | Edith | Psychiatric Unit | 2123 41st St, 1st Floor, Astoria, NY 11105-1708 | 2015-11-09 |
| 1306242763 | Rochester Institute of Technology | Psychiatric Unit | 1 Lomb Memorial Drive, Rochester, NY 14623 | 2014-11-13 |
| 1366868218 | Brian Connelly | Psychiatric Unit | 27 Cheryl Dr, Shoreham, NY 11786-2356 | 2014-03-14 |
| 1942544903 | Grand Manor Nursing Home | Psychiatric Unit | 922 E 222nd St, Apt 1, Bronx, NY 10469-1018 | 2012-11-15 |
| 1407126931 | Jon Ehinger | Psychiatric Unit | 441 16th St Apt 2r, Brooklyn, NY 11215-5892 | 2011-12-30 |
| 1497022800 | Creedmor Psychiatric Center | Psychiatric Unit | 7925 Winchester Boulevard, Creedmoor Psychiatric Center Medical Education, Queens Village, NY 11427 | 2011-11-30 |
| 1750608998 | Nyp Columbia | Psychiatric Unit | 4588 Broadway, 622 West 168th St, New York, NY 10040-2101 | 2010-04-28 |
| 1851617153 | Annette M Graffeo | Psychiatric Unit | 35 Marcus Rd, Ellenville, NY 12428-5762 | 2010-04-12 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGDALE |
| Zip Code | 11735 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.