STATEN ISLAND UNIVERSITY HOSPITAL (NPI# 1912925199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912925199 |
| Entity Type | Organization |
| Organization Name | STATEN ISLAND UNIVERSITY HOSPITAL |
| Practice Address |
475 Seaview Ave Staten Island NY 10305-3436 |
| Practice Telephone | 7182264502 |
| Practice Fax Number | 7182264875 |
| Mailing Telephone | 7182264502 |
| Mailing Fax Number | 7182264875 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-08-14 |
| Authorized Official Name | MS. MICHELE CUSACK (SVP AND CFO) |
| Authorized Official Telephone | 5163216058 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATEN ISLAND UNIVERSITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 7004003H | NY | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | BLUE CROSS PSYCH | 000881 | 01 |
| NY | 00244202 | 05 | |
| NJ | BLUE CROSS PSYCH | 330860 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164846317 | Staten Island University Hospital | General Acute Care Hospital | 14 Manchester Dr, Staten Island, NY 10312-1807 | 2014-02-07 |
| 1396755922 | Staten Island University Hospital | Hospice, Inpatient | 78 Meisner Ave, Staten Island, NY 10306-1234 | 2006-08-08 |
| 1144714171 | Staten Island University Hospital | Pharmacy | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2018-06-22 |
| 1649702424 | Staten Island University Hospital | General Acute Care Hospital | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2017-03-30 |
| 1447507579 | Staten Island University Hospital | General Acute Care Hospital | 375 Seguine Ave, Staten Island, NY 10309-3932 | 2012-08-08 |
| 1215283890 | Staten Island University Hospital | Student in an Organized Health Care Education/Training Program | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2012-08-01 |
| 1477815520 | Staten Island University Hospital | General Acute Care Hospital | 227 Koch Blvd, Staten Island, NY 10312-5416 | 2012-06-14 |
| 1093084659 | Staten Island University Hospital | Psychiatric Hospital | 375 Seguine Ave, Staten Island, NY 10309-3932 | 2011-12-27 |
| 1760751101 | Staten Island University Hospital | Clinic/Center | 567 E 105th St, Brooklyn, NY 11236-2213 | 2011-12-14 |
| 1881962298 | Staten Island University Hospital | Psychiatric Hospital | 392 Seguine Ave, Staten Island, NY 10309-3906 | 2011-12-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STATEN ISLAND UNIVERSITY HOSPITAL, INC | 475 Seaview Ave, Staten Island, NY 10305-3436 |
| Street Address |
475 SEAVIEW AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10305-3436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083611537 | Than Than Aye | Anesthesiology | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2005-06-30 |
| 1780285346 | Daphne Andrea Duran | Nurse Practitioner | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2020-11-02 |
| 1912505595 | Jennifer Ann Holtzbach | Nurse Practitioner | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2020-10-15 |
| 1649877564 | Michelle Ramsaroop | Physician Assistant | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2020-10-04 |
| 1174130694 | Juda Zurndorfer | Nurse Practitioner | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2020-09-29 |
| 1780299362 | Lorenzo Brown | Registered Nurse | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2020-09-10 |
| 1780294959 | Valerie Jioia | Physician Assistant | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2020-08-03 |
| 1679199368 | Madison Lynn Robbins | Physician Assistant | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2020-06-18 |
| 1598389678 | Brianna Nichole Hines | Student in an Organized Health Care Education/Training Program | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2020-06-03 |
| 1912521279 | Christina Valerio | Registered Nurse | 475 Seaview Ave, Staten Island, NY 10305-3436 | 2020-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972101517 | Gina Sinchi | Specialist | 120 Hylan Blvd Suite 9b1, Staten Island, NY 10305 | 2020-10-15 |
| 1003436783 | Ali Kassem | Student in an Organized Health Care Education/Training Program | 475 Seaview University, Staten Island, New York, Staten Island University Hospital, Department of Intern, Staten Island, Nyc, NY 10305 | 2020-04-22 |
| 1174183982 | Mohammad Ass'ad Alshami | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue Ht-257(back), Staten Island-nyc, NY 10305 | 2019-06-14 |
| 1639632508 | Abdullah Jahangir | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue Staten Island, Staten Island Univers, New York City, NY 10305 | 2019-04-09 |
| 1922593813 | Ifeyinwa Mary Asuzu | Student in an Organized Health Care Education/Training Program | 1 Edgewater Plaza Staten Island, New York, NY 10305 | 2018-06-25 |
| 1700377652 | Celeste Jude Chow | Speech-Language Pathologist | 841 Father Capodanno Blvd, Staten Island, NY 10305 | 2018-05-27 |
| 1972094878 | Mahmoud Shadi | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue; Staten Island Univeristy Hospital, Staten Island, NY 10305 | 2018-05-25 |
| 1396235131 | Samyak Hiteshkumar Dhruv | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue, Staten Island, NY 10305 | 2018-05-17 |
| 1720583404 | Michele Corrado | Nurse Practitioner | 27 Xenia St, Staten Island, NY 10305 | 2018-03-26 |
| 1861995912 | Erika Renick | Dietitian, Registered | 256 Mason Avenue, Building C - 3rd Floor, Staten Island, NY 10305 | 2018-03-15 |
| Find all providers in zip 10305 | ||||
| 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 |
|---|---|---|---|---|
| 1184873135 | Richmond Medical Center | Psychiatric Unit | 355 Bard Ave, Staten Island, NY 10310-1664 | 2008-09-15 |
| 1003983370 | Saint Vincent Catholic Medical Center | Psychiatric Unit | 355 Bard Ave, Staten Island, NY 10310-1664 | 2006-11-29 |
| 1740389154 | Richmond Medical Center | Psychiatric Unit | 355 Bard Ave, Staten Island, NY 10310-1664 | 2006-09-22 |
| 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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| City | STATEN ISLAND |
| Zip Code | 10305 |
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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.