LIFEPLAN CCO NY, LLC (NPI# 1417457789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417457789 |
| Entity Type | Organization |
| Organization Name | LIFEPLAN CCO NY, LLC |
| Practice Address |
1020 Mary St Utica NY 13501-1930 |
| Mailing Address |
22 Corporate Woods Blvd Albany NY 12211-2374 |
| Practice Telephone | 3157246907 |
| Mailing Telephone | 5189442100 |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2018-02-13 |
| Authorized Official Name | ALAN KRAFCHIN (BOARD CHAIR) |
| Authorized Official Telephone | 5189442100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
1020 MARY ST |
| City | UTICA |
| State | NY |
| Zip Code | 13501-1930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679516249 | Debra Ann Carlson | Speech-Language Pathologist | 1020 Mary St, Utica, NY 13501-1930 | 2006-06-13 |
| 1215415583 | Michele Denise Campola | Specialist | 1020 Mary St, Utica, NY 13501-1930 | 2018-07-30 |
| 1396151791 | Cnyhhn Inc | Case Management | 1020 Mary St, Utica, NY 13501-1930 | 2014-07-07 |
| 1013334689 | Linda Jean Cammiso | Specialist | 1020 Mary St, Utica, NY 13501-1930 | 2014-03-21 |
| 1508296328 | Sarah Murray | Occupational Therapist | 1020 Mary St, Utica, NY 13501-1930 | 2013-11-14 |
| 1790039477 | Denise M Williams | Registered Nurse | 1020 Mary St, Utica, NY 13501-1930 | 2012-11-02 |
| 1891045902 | Central New York Health Home Network, LLC | Case Management | 1020 Mary St, Utica, NY 13501-1930 | 2012-09-17 |
| 1669760617 | Tamela Zecca | Occupational Therapy Assistant | 1020 Mary St, Utica, NY 13501-1930 | 2011-07-12 |
| 1285927541 | Caitlin Erin Mahoney | Speech-Language Pathologist | 1020 Mary St, Utica, NY 13501-1930 | 2011-05-19 |
| 1992017511 | Jennifer Ann Wolak | Speech-Language Pathologist | 1020 Mary St, Utica, NY 13501-1930 | 2010-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700349248 | Maria Kuehl | Student in an Organized Health Care Education/Training Program | 120 Hobart Street, Residency Program, Utica, NY 13501 | 2019-04-11 |
| 1497237622 | Bobs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 430 Bleecker St, Utica, NY 13501 | 2018-09-04 |
| 1528565421 | Michele Della Gala | Social Worker | 1427 Genesee Street, Utica, NY 13501 | 2018-04-09 |
| 1295274884 | Sheila Denita Boyd | Licensed Practical Nurse | 505 Mary Street, Utica, NY 13501 | 2017-02-16 |
| 1770034993 | Curry Mcmahon | Massage Therapist | 2707 Genesee St, Utica, NY 13501 | 2016-10-24 |
| 1689123614 | Angelica Pascone Martin | Physician Assistant | 2215 Genesee St., Utica, NY 13501 | 2016-10-03 |
| 1942673942 | Krista Lee Klopotek | Registered Nurse | 1151 Albany Street, Albany Elementary School, Utica, NY 13501 | 2015-11-12 |
| 1841618089 | Katherine Macaulay Lucey | Social Worker | 293 Genesee Street, The Neighborhood Center, Inc. Human Resources, Utica, NY 13501 | 2014-04-04 |
| 1578809067 | Laurie A Baker | Social Worker | 2307 Genesee St, Utica, NY 13501 | 2013-01-02 |
| 1104170505 | Amanda Knoeller | Social Worker | 683 Mary Street, Utica, NY 13501 | 2012-11-07 |
| Find all providers in zip 13501 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023364551 | Christine M Andrews | Case Manager/Care Coordinator | 185 Genesee St Fl 4, Utica, NY 13501-2102 | 2012-08-02 |
| 1912558149 | Deanna Michelle Talarico | Case Manager/Care Coordinator | 130 Lomond Ct Ste 1, Utica, NY 13502-5951 | 2019-09-29 |
| 1558912493 | Marie Theresa Mccormick | Case Manager/Care Coordinator | 130 Lomond Ct, Utica, NY 13502-5957 | 2019-09-23 |
| 1184153215 | Danielle Marie Gazzilli | Case Manager/Care Coordinator | 245 Genesee St, Utica, NY 13501-3401 | 2017-06-12 |
| 1699203703 | Kailee Coffin | Case Manager/Care Coordinator | 245 Genesee St, Utica, NY 13501-3401 | 2017-06-02 |
| 1639607187 | Megan Coleman | Case Manager/Care Coordinator | 245 Genesee St, Utica, NY 13501-3401 | 2017-05-30 |
| 1235666223 | Amanda Lally | Case Manager/Care Coordinator | 245 Genesee St, Utica, NY 13501-3401 | 2017-05-22 |
| 1114399847 | Denise Slack | Case Manager/Care Coordinator | 185 Genesee St, Utica, NY 13501-2102 | 2015-10-21 |
| 1215318357 | Kirstie Gorgas | Case Manager/Care Coordinator | 326 Catherine St, Utica, NY 13501-1209 | 2015-06-15 |
| 1962825661 | Kimberly Brucker | Case Manager/Care Coordinator | 185 Genesee St, Utica, NY 13501-2102 | 2014-01-31 |
| Find all providers in UTICA | ||||
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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.