NEWARK WAYNE COMMUNITY HOSPITAL (NPI# 1902989221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902989221 |
| Entity Type | Organization |
| Organization Name | NEWARK WAYNE COMMUNITY HOSPITAL |
| Other Organization Name | NEWARK WAYNE COMM HOSP - PSYCH |
| Practice Address |
1200 Driving Park Ave Newark NY 14513-1057 |
| Practice Telephone | 3153322022 |
| Mailing Telephone | 3153322022 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2014-06-24 |
| Authorized Official Name | PAULA TINCH (SVP-FINANCE) |
| Authorized Official Telephone | 5859221223 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 5820000H | NY | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00354458 | 05 | |
| NY | HEALTHNOW PSYCH | 000900002001 | 01 |
| NY | BLUECHOICE INPATIENT PSY | 0120026XY | 01 |
| NY | BLUESHIELD OUTPT PSYCH | 97 | 01 |
| NY | PREFERREDCARE PSYCH | HO130P | 01 |
| NY | BLUESHIELD INPATIENT PSY | XY | 01 |
| Other Name | Type Code |
|---|---|
| Newark Wayne Comm Hosp - Psych | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780752568 | Newark Wayne Community Hospital | Skilled Nursing Facility | 100 Sunset Dr, Newark, NY 14513-1068 | 2006-12-01 |
| 1851594774 | Newark Wayne Community Hospital | Skilled Nursing Facility | 1200 Driving Park Ave, Newark, NY 14513-1057 | 2007-06-07 |
| 1346369212 | Newark Wayne Community Hospital | General Acute Care Hospital | 1200 Driving Park Ave, Newark, NY 14513-1057 | 2007-03-29 |
| 1295803070 | Newark Wayne Community Hospital | Skilled Nursing Facility | 100 Sunset Dr, Newark, NY 14513-1068 | 2006-12-01 |
| 1770671182 | Newark Wayne Community Hospital | General Acute Care Hospital | 1200 Driving Park Ave, Pob 111 Driving Park Ave, Newark, NY 14513-1057 | 2006-10-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NEWARK WAYNE COMMUNITY HOSPITAL | 1250 Driving Park Ave, Newark, NY 14513-1057 |
| Street Address |
1200 DRIVING PARK AVE |
| City | NEWARK |
| State | NY |
| Zip Code | 14513-1057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396741898 | Lawrence N. Chessin | Internal Medicine | 1200 Driving Park Ave, Newark, NY 14513-1057 | 2005-06-21 |
| 1477162725 | Aidan Sullivan | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2020-07-23 |
| 1649898834 | Nicholas D Biermann | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2020-07-14 |
| 1780222604 | Erin Hart | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-12-11 |
| 1861030785 | Lauren Conaty | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-12-11 |
| 1255978540 | Andrea Lorene Ide | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-12-05 |
| 1326682618 | Thomas William Jackson Mspt | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-10-30 |
| 1578113189 | Natalie A Davidson | Nurse Practitioner | 1200 Driving Park Ave, Newark, NY 14513 | 2019-09-16 |
| 1164076659 | Meritt F Rogers | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-08-01 |
| 1992366744 | Allison Marie Triou | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-06-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881215648 | Susan Marie Oberdorf | Speech-Language Pathologist | 133 Elmwood, Newark, NY 14513 | 2020-05-04 |
| 1871077404 | Aisha E Wagner | Nurse Practitioner | 1304 Driving Park Avenue, Newark, NY 14513 | 2018-09-19 |
| 1689192817 | Melanie Swarthout | Case Manager/Care Coordinator | 150 Van Buren St., Newark, NY 14513 | 2017-09-08 |
| 1942650882 | Donna Joy Collins I | Speech-Language Pathologist | 848 Pierson Avenue, Newark, NY 14513 | 2016-06-21 |
| 1972952661 | Cj-mak Transportation, Inc. | Non-emergency Medical Transport (VAN) | 227 State Farm Road, Newark, NY 14513 | 2016-06-03 |
| 1306214473 | Stephanie Belli | Licensed Practical Nurse | 5904 Austin Road, Newark, NY 14513 | 2015-09-08 |
| 1992186712 | Nicole Harris | Nursing Facility/Intermediate Care Facility | 132 Willow Avenue, Newark, NY 14513 | 2015-06-17 |
| 1861802373 | Jeffrey Spencer | Urology | 1202 Driving Park Ave Ste 5, Newark, NY 14513 | 2014-05-06 |
| 1609126648 | Natasha Triplett | Student in an Organized Health Care Education/Training Program | 439 W. Maple Ave, Perkins Elementary, Newark, NY 14513 | 2012-09-18 |
| 1922377902 | Lisa E. Williams | Licensed Practical Nurse | 701 Peirson Ave., Newark, NY 14513 | 2011-12-21 |
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| 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 |
|---|---|---|---|---|
| 1811398068 | Synapse Behavioral Medicine LLC | Psychiatric Unit | 201 Lyons Ave, Nbimc, Newark, NJ 07112-2027 | 2014-09-08 |
| 1740558832 | Saint Michael's Medical Center | Psychiatric Unit | 155 Jefferson St, Newark, NJ 07105-1706 | 2011-12-05 |
| 1043457955 | Newark Beth Israel Medical Center Inc | Psychiatric Unit | 201 Lyons Ave, Newark, NJ 07112-2027 | 2009-01-14 |
| 1215027966 | Newark Beth Israel Medical Center Inc | Psychiatric Unit | 201 Lyons Ave, Newark, NJ 07112 | 2006-10-13 |
| 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 |
| 1104253772 | Pederson-krag | Psychiatric Unit | 77 Radcliffe Ave., Farmingdale, NY 11735 | 2013-09-27 |
| 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 |
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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.