ALICE HYDE MEDICAL CENTER (NPI# 1568735660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568735660 |
| Entity Type | Organization |
| Organization Name | ALICE HYDE MEDICAL CENTER |
| Other Organization Name | ALICE HYDE MEDICAL PRACTICES |
| Practice Address |
133 Park St Malone NY 12953-1243 |
| Mailing Address |
133 Park St Malone NY 12953-1244 |
| Practice Telephone | 5184812212 |
| Practice Fax Number | 5184812662 |
| Mailing Telephone | 5184833000 |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2020-03-24 |
| Authorized Official Name | MR. CHRIS HICKEY (CFO) |
| Authorized Official Telephone | 5184818067 |
| Is Organization Subpart | Y |
| Parent Organization Name | ALICE HYDE MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Alice Hyde Medical Practices | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184007809 | Alice Hyde Medical Center | Home Health | 45 Sixth St, Malone, NY 12953 | 2015-06-30 |
| 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 |
| 1114954682 | Alice Hyde Medical Center | Clinic/Center | 133 Park St, Malone, NY 12953-1220 | 2006-06-28 |
| 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 | 12953-1243 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
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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.