NYSARC INC NYC CHAPTER (NPI# 1477620581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477620581 |
| Entity Type | Organization |
| Organization Name | NYSARC INC NYC CHAPTER |
| Practice Address |
55 Galloway Ave Staten Island NY 10302-2527 |
| Mailing Address |
83 Maiden Ln 11 Th Floor New York NY 10038-4812 |
| Practice Telephone | 2127802631 |
| Practice Fax Number | 2127775893 |
| Mailing Telephone | 2127802631 |
| Mailing Fax Number | 2127775893 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROBERT C GOLDSMITH (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 2127802692 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NYS OMRDD OPERATING CERT | 6198444 | 01 |
| NY | 00356794 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649591561 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 126 E 126th Street, Apt 6d, New York, NY 10035-1702 | 2010-06-15 |
| 1629257381 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 16120 89th Ave, Apt 2a, Jamaica, NY 11432-3901 | 2007-10-30 |
| 1285701383 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 141 W 4th St, New York, NY 10012-1010 | 2006-11-30 |
| 1346317450 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 200 Tysen St, Staten Island, NY 10301-1120 | 2006-11-30 |
| 1639246796 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 224 E 5th St, New York, NY 10003-8501 | 2006-11-30 |
| 1225105349 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 9520 95th St, Ozone Park, NY 11416-1607 | 2006-11-30 |
| 1285701326 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 1427 117th St, College Point, NY 11356-1545 | 2006-11-30 |
| 1578630604 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 1207 Ditmas Ave, Brooklyn, NY 11218-6031 | 2006-11-30 |
| 1043387186 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 3817 Bailey Ave, Bronx, NY 10463-2503 | 2006-11-30 |
| 1790852820 | Nysarc Inc Nyc Chapter | Intermediate Care Facility, Mentally Retarded | 6621 Marathon Pkwy, Little Neck, NY 11362-2350 | 2006-11-30 |
| Street Address |
55 GALLOWAY AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10302-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306494174 | Denasia Fitch | Student in an Organized Health Care Education/Training Program | 80 Willowbrook Rd, Staten Island, NY 10302 | 2019-08-26 |
| 1548752983 | Lawan Rickenbacker | Counselor | 28 Treadwell Ave, Staten Island, NY 10302 | 2018-06-01 |
| 1275059321 | Omolara Rachael Adediji | Nurse Practitioner | 210 Trantor Place, Apt 1d, Staten Island, NY 10302 | 2017-08-21 |
| 1558893479 | Joseph Wilson | Substance Abuse Rehabilitation Facility | 273 Heberton Avenue, Staten Island, NY 10302 | 2017-03-30 |
| 1902358864 | Natalie Valencia Toney-zubairu | Nurse Practitioner | Community Health Center of Richmond, 235 Port Richmond Ave, Staten Island, NY 10302 | 2016-10-26 |
| 1912453788 | Adewunmi Bankole | Registered Nurse | 124 Nicholas Avenue Apt B, Staten Island, NY 10302 | 2016-08-31 |
| 1154788974 | Eileen Patricia Cameron | Counselor | 263-267 Port Richmond Aveune, Staten Island, NY 10302 | 2016-01-25 |
| 1225468432 | Total Dental Care of Staten Island, P.C. | Dentist | 135 Willowbrook Road, Staten Island, NY 10302 | 2013-11-25 |
| 1760723621 | Si. Senior Lifestyle Center Inc | Clinic/Center | 98 Port Richmond Ave, Staten Island, NY 10302 | 2013-03-01 |
| 1962751255 | Kathleen Gomez-rodriguez | Speech-Language Pathologist | 12 Crystal Ave, Staten Island, NY 10302 | 2012-09-03 |
| Find all providers in zip 10302 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780863589 | Association for The Advancement of Blind and Retarded Inc | Intermediate Care Facility, Mentally Retarded | 158 Cromwell Avenue, Staten Island, NY 10304 | 2007-10-29 |
| 1134338353 | United Cerebral Palsy of New York City, Inc. | Intermediate Care Facility, Mentally Retarded | 185 Saint Marks Pl, Apts. 2l-m, Staten Island, NY 10301-1670 | 2007-05-22 |
| 1861606048 | United Cerebral Palsy of New York City Inc | Intermediate Care Facility, Mentally Retarded | 165 Saint Marks Pl, Apts 2a 2b, Staten Island, NY 10301-1669 | 2007-05-09 |
| 1073726188 | Lifespire, Inc. | Intermediate Care Facility, Mentally Retarded | 107 Jumel St, Staten Island, NY 10308-1720 | 2007-05-07 |
| 1134332257 | Lifespire, Inc. | Intermediate Care Facility, Mentally Retarded | 146 South Ave, Staten Island, NY 10303-1665 | 2007-05-07 |
| 1932322518 | United Cerebral Palsy Assoc of Nys | Intermediate Care Facility, Mentally Retarded | 35 Sharrotts Rd, Staten Island, NY 10309-1953 | 2007-04-11 |
| 1225150030 | United Cerebral Palsy Assoc of Nys Inc | Intermediate Care Facility, Mentally Retarded | 455 Medina St, Staten Island, NY 10306-4435 | 2007-04-04 |
| 1518089390 | United Cerebral Palsy Assoc of Nys | Intermediate Care Facility, Mentally Retarded | 64 Madsen Ave, Staten Island, NY 10309-2608 | 2007-04-04 |
| 1548382393 | United Cerebral Palsy Assoc of Nys | Intermediate Care Facility, Mentally Retarded | 17 Scarboro Ave, Staten Island, NY 10305-3118 | 2007-04-04 |
| 1023150398 | Eden II School for Autistic Children | Intermediate Care Facility, Mentally Retarded | 150 Granite Avenue, Staten Island, NY 10303 | 2007-02-13 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10302 |
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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.