ALICE HYDE MEDICAL CENTER (NPI# 1114954682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114954682 |
| Entity Type | Organization |
| Organization Name | ALICE HYDE MEDICAL CENTER |
| Practice Address |
133 Park St Malone NY 12953-1220 |
| Practice Telephone | 5184812212 |
| Practice Fax Number | 5184812662 |
| Mailing Telephone | 5184812847 |
| Mailing Fax Number | 5184812818 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2019-04-24 |
| Authorized Official Name | MR. SCOTT ST. GEORGE (CFO) |
| Authorized Official Telephone | 5184812847 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| Y | 282N00000X | General Acute Care Hospital | 1624000H | NY | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00354114 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184007809 | Alice Hyde Medical Center | Home Health | 45 Sixth St, Malone, NY 12953 | 2015-06-30 |
| 1568735660 | Alice Hyde Medical Center | Dermatology | 133 Park St, Malone, NY 12953-1243 | 2012-02-21 |
| 1730401381 | Alice Hyde Medical Center | Internal Medicine | 133 Park St, Malone, NY 12953-1243 | 2010-02-24 |
| 1578627865 | Alice Hyde Medical Center | General Acute Care Hospital | 133 Park St, Malone, NY 12953-1243 | 2006-12-20 |
| 1356441349 | Alice Hyde Medical Center | Skilled Nursing Facility | 133 Park St, Malone, NY 12953-1220 | 2006-09-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ALICE HYDE MEDICAL CENTER | 133 Park St, Malone, NY 12953-1243 |
| New York State Corporations | ALICE HYDE MEDICAL CENTER | 115 Park Street, Malone, Ny 12953 |
| Street Address |
133 PARK ST |
| City | MALONE |
| State | NY |
| Zip Code | 12953-1220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578557799 | William D Mccarthy | Nurse Anesthetist, Certified Registered | 133 Park St, Malone, NY 12953-1220 | 2005-09-02 |
| 1811537608 | Qi Si Xue | Nurse Practitioner | 133 Park St, Malone, NY 12953-1244 | 2020-01-09 |
| 1558897801 | Shalin Nitin Shah | Internal Medicine | 133 Park St, Malone, NY 12953-1244 | 2017-05-05 |
| 1437696390 | Alice Hyde Medical Center Eip | Early Intervention Provider Agency | 133 Park St, Malone, NY 12953-1244 | 2017-01-30 |
| 1699127795 | Brianne Jeror | Nurse Practitioner | 133 Park St, Malone, NY 12953-1244 | 2016-07-13 |
| 1598148967 | Joshua A Craig | Nurse Practitioner | 133 Park St, Malone, NY 12953-1243 | 2015-07-03 |
| 1194107789 | Jessica Marie Robinson | Nurse Practitioner | 133 Park St, Malone, NY 12953-1243 | 2015-06-19 |
| 1215364856 | Megan Leelannee Bristol | Pharmacist | 133 Park St, Malone, NY 12953-1243 | 2013-09-27 |
| 1598105942 | Yasmina Tbeur | Internal Medicine | 133 Park St, Malone, NY 12953-1244 | 2013-06-30 |
| 1578907044 | Ann Griffith | Nurse Practitioner | 133 Park St, Malone, NY 12953-1243 | 2013-04-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386264356 | Ruth Ann Williamson | Nurse Practitioner | 31 Sixth St., Malone, NY 12953 | 2020-04-20 |
| 1780203760 | Heather Lynn Lauzon | Peer Specialist | 15 Fouth St, Malone, NY 12953 | 2020-04-10 |
| 1245717115 | Darlean James | Family Medicine | 183 Park St Ste 5678, Malone, NY 12953 | 2018-07-24 |
| 1164929212 | Cheryl Ann Grant | Registered Nurse | 15 Fourth Street, Malone, NY 12953 | 2018-04-06 |
| 1811408826 | Nancy Denis | Registered Nurse | 133 Park Street, Alice Hyde Medical Center, Malone, NY 12953 | 2017-10-17 |
| 1003325424 | Tara Lynn Ellis | Registered Nurse | 23 Husky Lane, Malone, NY 12953 | 2017-09-28 |
| 1578092185 | Shanna Lee Cayea | Peer Specialist | 31 6th Street, Malone, NY 12953 | 2017-06-07 |
| 1184007809 | Alice Hyde Medical Center | Home Health | 45 Sixth St, Malone, NY 12953 | 2015-06-30 |
| 1427303353 | Melissa J Benardot | Nurse Practitioner | 380 Cty Rt 57, Community Health Center, Malone, NY 12953 | 2012-07-17 |
| 1013272202 | Shafiu Oladele Ololade | Internal Medicine | 10 Third Street, Malone, NY 12953 | 2012-07-12 |
| Find all providers in zip 12953 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225507114 | University Hospital At Stony Brook | General Acute Care Hospital | 740 County Road 39, Southampton, NY 11968-5090 | 2018-11-20 |
| 1184108144 | Samaritan Hospital of Troy, New York | General Acute Care Hospital | 500 Federal St Ste 602, Troy, NY 12180-2832 | 2018-09-17 |
| 1225559149 | Zulfa Omer | General Acute Care Hospital | 234 E 149th St Ste 20-8, Bronx, NY 10451-5504 | 2017-06-30 |
| 1992230171 | Ny Presbyterian-queens | General Acute Care Hospital | 85-88 Parsons Blvd., Jamaica, NY 11432 | 2017-04-26 |
| 1760916324 | Nayab Chowhan | General Acute Care Hospital | 818 Friel Pl, Brooklyn, NY 11218-2609 | 2017-04-20 |
| 1629509146 | Luke Alessi | General Acute Care Hospital | 207 Bayville Ave, Bayville, NY 11709-1652 | 2017-03-26 |
| 1376083378 | Department of Education | General Acute Care Hospital | 923 Elton Street, 2nd Floor, Brooklyn, NY 11208 | 2017-02-24 |
| 1255878492 | Winthrop University Hospital | General Acute Care Hospital | 212 Jericho Turnpike, Mineola, NY 11501 | 2017-01-26 |
| 1316480353 | Compassionate Companion Care, Pllc | General Acute Care Hospital | 204 Hendy Creek Rd, Pine City, NY 14871-9760 | 2016-11-23 |
| 1164964078 | Adrielle Ofosu | General Acute Care Hospital | 84 Kimball Ave, Yonkers, NY 10704-4222 | 2016-11-09 |
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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.