Covered Entity Details

DSH330101FZ NEW YORK-PRESBYTERIAN HOSPITAL (Active) - information as of 4/23/2025 10:54:07 PM

Main Details

Name

NEW YORK-PRESBYTERIAN HOSPITAL

Subdivision Name

CCH - Ambulatory Services

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH330101FZ

Medicare Provider Number

330101

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/6/2023

Participating Start Date

10/1/2023

Participating Approval Date

8/30/2023

Last Recertification Date

8/23/2024

Contacts

Authorizing Official

New York Presbyterian
William Farrell, SVP, Finance
(212) 297-4358

Primary Contact

NewYork-Presbyterian Hospital
Gajendra Gharia, Director of Finance, Dept of 340B Programs
(212) 297-4353

Addresses

Street Address

515 6th Street
2nd Floor
Brooklyn, NY 11215

Billing Address

NewYork-Presbyterian Hospital
525 East 68th Street
New York, NY 10065

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
NY	02998658	1952332801
NJ	4152301	1952332801

Shipping Addresses

Shipping Address 1

NewYork-Presbyterian Brooklyn Methodist Hospital Center for Community Health
515 Sixth St.
6th Floor - Pharmacy
Brooklyn, NY 11215-3609

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH330101AA	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Audubon Family Planning Practice	21 Audubon Avenue	New York	NY	Active
DSH330101AD	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	John F. Kennedy High School Clinic	99 Terrace View Avenue	Bronx	NY	Active
DSH330101AE	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	ACN ALLEN HOSPITAL PRACTICE	5141 Broadway	New York	NY	Terminated
DSH330101AF	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	OPERATING ROOMS MILSTEIN 3 AND 4	177 Fort Washington Ave.	New York	NY	Active
DSH330101AG	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Comprehensive Cancer Center	161 Fort Washington Avenue	New York	NY	Active
DSH330101AH	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	EYE 4 AMBULATORY SURGERY UNIT	635 West 165th Street	New York	NY	Terminated
DSH330101AJ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	PERINATAL CLINIC	21 Audubon Avenue	New York	NY	Active
DSH330101AK	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Recovery Rooms-Milstein 3 and 4	177 Fort Washington Avenue	New York	NY	Active
DSH330101AL	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CYSTOSCOPY	173 Fort Washington Avenue	New York	NY	Active
DSH330101AM	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	MILSTEIN EMERGENCY	630 West 168th Street	New York	NY	Active
DSH330101AN	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	MILSTEIN EMERGENCY B	630 West 168th Street	New York	NY	Terminated
DSH330101AP	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	MILSTEIN CARDIAC CATHETERIZATION LAB	177 Fort Washington Avenue	New York	NY	Active
DSH330101AQ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	VANDERBILT CLINIC CT SCAN	622 West 168th Street	New York	NY	Active
DSH330101AR	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	INTERVENTIONAL NEURORADIOLOGY	177 Fort Washington Avenue	New York	NY	Active
DSH330101AS	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NEUROLOGY ICU - CT SCAN	177 Fort Washington Avenue	New York	NY	Active
DSH330101AT	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	MRI - PRESBYTERIAN HOSPITAL	622 West 168th Street	New York	NY	Active
DSH330101AU	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	MRI - HIP	161 Fort Washington Avenue	New York	NY	Active
DSH330101AV	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	ULTRASOUND - MILSTEIN	177 Fort Washington Avenue	New York	NY	Active
DSH330101AW	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CT SCAN - MILSTEIN 4	177 Fort Washington Avenue	New York	NY	Active
DSH330101AX	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CT SCAN - HIP	161 Fort Washington Avenue	New York	NY	Active
DSH330101AY	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CT SCAN - BABIES	3959 Broadway	New York	NY	Active
DSH330101AZ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CT SCAN - MILSTEIN 3	177 Fort Washington Avenue	New York	NY	Active
DSH330101BA	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	MRI - NEUROLOGY ICU	177 Fort Washington Avenue	New York	NY	Active
DSH330101BB	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	X-RAY VANDERBILT CLINIC EMERGENCY	622 West 168th Street	New York	NY	Terminated
DSH330101BC	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	X-RAY BABIES HOSPITAL	3959 Broadway	New York	NY	Active
DSH330101BD	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	VASCULAR INTERVENTIONAL	177 Fort Washington Avenue	New York	NY	Terminated
DSH330101BE	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NUCLEAR MEDICINE - MILSTEIN 3	177 Fort Washington Avenue	New York	NY	Active
DSH330101BF	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NUCLEAR CARDIOLOGY	177 Fort Washington Ave	New York	NY	Active
DSH330101BH	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	AIM PRACTICE EAST	1150 St. Nicholas Avenue	New York	NY	Active
DSH330101BJ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	SUPPORT SERVICE LAB	622 West 168th Street	New York	NY	Terminated
DSH330101BK	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS INTERVENTIONAL RADIOLOGY	3959 Broadway	New York	NY	Active
DSH330101BL	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS DIAGNOSTIC IMAGING	3959 Broadway	New York	NY	Active
DSH330101BM	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS ONCOLOGY CENTER	161 Fort Washington Avenue	New York	NY	Active
DSH330101BN	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS CARDIAC DIAGNOSTIC CENTER	3959 Broadway	New York	NY	Active
DSH330101BP	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS PULMONARY FUNCTION AND CARDIAC STRESS LAB	3959 Broadway	New York	NY	Active
DSH330101BQ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	MAMMOGRAPHY	161 Fort Washington Avenue	New York	NY	Active
DSH330101BR	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS INFUSION CENTER	3959 Broadway	New York	NY	Active
DSH330101BT	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS RADIOLOGY	3959 Broadway	New York	NY	Active
DSH330101BU	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS EMERGENCY ROOM	3959 Broadway	New York	NY	Active
DSH330101BV	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS PACU	3959 Broadway	New York	NY	Active
DSH330101BW	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS OPERATING ROOM	3959 Broadway	New York	NY	Active
DSH330101BX	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Comprehensive Health Program	180 Ft. Washington Avenue	New York	NY	Active
DSH330101BY	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	X-RAY ALLEN HOSPITAL	5141 Broadway	New York	NY	Active
DSH330101BZ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	GAMMA KNIFE	3959 Broadway	New York	NY	Active
DSH330101CA	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	OPERATING ROOM ALLEN HOSPITAL	5141 Broadway	New York	NY	Active
DSH330101CB	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CARDIAC DIAGNOSTIC CENTER ALLEN HOSPITAL	5141 Broadway	New York	NY	Terminated
DSH330101CC	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	ENDOSCOPY ALLEN HOSPITAL	5141 Broadway	New York	NY	Active
DSH330101CD	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS URODYNAMICS	3959 Broadway	New York	NY	Terminated
DSH330101CE	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	COMPREHENSIVE TRANSPLANT	622 West 168th Street	New York	NY	Active
DSH330101CF	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	COLUMBIA PULMONARY FUNCTION LAB	622 West 168th Street	New York	NY	Active
DSH330101CG	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	AIM Practice West	622 West 168th Street	New York	NY	Active
DSH330101CH	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	ECHOCARDIOLOGY	177 Fort Washington Avenue	New York	NY	Terminated
DSH330101CJ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	ENDOSCOPY PRESBYTERIAN HOSPITAL	161 Fort Washington Avenue	New York	NY	Active
DSH330101CK	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	PHYSICAL MEDICINE CLINIC	622 West 168th Street	New York	NY	Terminated
DSH330101CM	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Dermatology	161 Fort Washington Ave.	New York	NY	Active
DSH330101CN	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	COLUMBIA EYE CLINIC	622 West 168th Street	New York	NY	Active
DSH330101CP	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	COLUMBIA CLINIC ORTHOPEDIC	710 West 168th Street	New York	NY	Active
DSH330101CQ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	COLUMBIA CLINIC SPECIALITIES	622 West 168th Street	New York	NY	Active
DSH330101CR	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Continuing Day Treatment Program	21 Bloomingdale Road	White Plains	NY	Terminated
DSH330101CS	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Continuum of Care Clinic	21 Bloomingdale Road	White Plains	NY	Terminated
DSH330101CT	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	WIC 168TH STREET	622 West 168th Street	New York	NY	Terminated
DSH330101CU	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	WIC NAGLE AVENUE	68 Nagle Avenue	New York	NY	Terminated
DSH330101CV	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	WIC 180TH STREET	549 West 180th Street	New York	NY	Terminated
DSH330101CW	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Women's Health/Special Needs	622 West 168th Street	New York	NY	Terminated
DSH330101CX	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CARDIAC HEALTH CENTER	1153 York Avenue	New York	NY	Terminated
DSH330101CZ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	ADULT METHADONE	505 East 70th Street	New York	NY	Active
DSH330101DA	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	WOMENS HEALTH PRACTICE	505 East 70th Street	New York	NY	Active
DSH330101DB	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	PEDIATRICS HEALTH PRACTICE	505 East 70th Street	New York	NY	Active
DSH330101DC	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CHILDRENS ENDOSCOPY AND BRONCHOSCOPY	3959 Broadway	New York	NY	Active
DSH330101DD	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital Radiology	170 William Street	New York	NY	Active
DSH330101DE	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital Interventional Radiology	170 William Street	New York	NY	Active
DSH330101DF	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital Endoscopy	170 William Street	New York	NY	Active
DSH330101DG	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital Ambulatory Surgery	170 William Street	New York	NY	Terminated
DSH330101DH	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital Wellness Center	170 William Street	New York	NY	Terminated
DSH330101DJ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital Operating Room	170 William Street	New York	NY	Active
DSH330101DK	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital PACU	170 William Street	New York	NY	Terminated
DSH330101DL	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital Infusion Center	170 William Street	New York	NY	Active
DSH330101DM	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital Emergency	170 William Street	New York	NY	Active
DSH330101DN	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Harkness Pavilion / Hemotherapy/Apheresis	180 Fort Washington Avenue	New York	NY	Active
DSH330101DP	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Presbyterian Hospital / Renal Dialysis	622 West 168th Street	New York	NY	Active
DSH330101DQ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Project Stay - Youth Access	622 West 168th Street	NEW YORK	NY	Active
DSH330101DR	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Allen Hospital / Emergency Department	5141 Broadway	New York	NY	Active
DSH330101DS	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Allen Hospital / L&D	5141 Broadway	New York	NY	Terminated
DSH330101DT	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Allen Hospital / Radiology	5141 Broadway	New York	NY	Active
DSH330101DU	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Allen Hospital / PACU	5141 Broadway	New York	NY	Terminated
DSH330101DV	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	MSCH / L&D	3959 Broadway	New York	NY	Active
DSH330101DW	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	PH / Psych CPEP	622 West 168th Street	New York	NY	Terminated
DSH330101DX	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	PH /Radiation Oncology	622 West 168th Street	New York	NY	Active
DSH330101DY	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Dental Clinic NYP/CU	99 Fort Washington Ave	New York	NY	Active
DSH330101DZ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Pediatric Dental Clinic	505 East 70th Street	New York	NY	Active
DSH330101E	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Columbia Hospital- Blood Bank	180 Fort Washington Avenue	New York	NY	Terminated
DSH330101EA	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Adult Psychiatry Clinic - Psychiatry	622 West 168th Street	New York	NY	Active
DSH330101EB	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Pediatric Psychiatry Clinic - Psychiatry	3959 Broadway	New York	NY	Active
DSH330101EC	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	DHK Radiation Oncology	1283 York Avenue	New York	NY	Active
DSH330101ED	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	DHK Ambulatory Surgery	1283 York Avenue	New York	NY	Active
DSH330101EE	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	DHK Endoscopy - Surgery	1283 York Avenue	New York	NY	Active
DSH330101EF	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	DHK Interventional Radiology	1283 York Avenue	New York	NY	Active
DSH330101EG	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	DHK Infusion - Oncology	1283 York Avenue	New York	NY	Active
DSH330101EH	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Radiology Diagnostic	55 Palmer Avenue	Bronxville	NY	Active
DSH330101EJ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Interventional Radiology	55 Palmer Avenue	Bronxville	NY	Active
DSH330101EK	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Radiology Therapy	55 Palmer Avenue	Bronxville	NY	Active
DSH330101EL	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Operating Room	55 Palmer Avenue	Bronxville	NY	Active
DSH330101EM	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Cardiac Cath Lab	55 Palmer Avenue	Bronxville	NY	Active
DSH330101EN	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Ambulatory Surgery - Operating Room	55 Palmer Avenue	Bronxville	NY	Terminated
DSH330101EP	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Cancer Center Medical Oncology	55 Palmer Avenue	Bronxville	NY	Active
DSH330101EQ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Lab Patient Service Center	55 Palmer Avenue	Bronxville	NY	Active
DSH330101ER	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Emergency Room	55 Palmer Avenue	Bronxville	NY	Active
DSH330101ES	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW Respiratory Therapy	55 Palmer Avenue	Bronxville	NY	Terminated
DSH330101ET	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Allen Hospital / Geriatrics	5141 Broadway	New York	NY	Active
DSH330101EU	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Vascular Lab	506 6th Street	Brooklyn	NY	Active
DSH330101EV	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Rehabilitation Medicine	506 6th Street	Brooklyn	NY	Active
DSH330101EW	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Radiology	506 6th Street	Brooklyn	NY	Active
DSH330101EX	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Bay Ridge Nuclear Cardiology	8721 5th Avenue	Brooklyn	NY	Active
DSH330101EY	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - CT	506 6th Street	Brooklyn	NY	Active
DSH330101EZ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - L&D OR	506 6th Street	Brooklyn	NY	Active
DSH330101F	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Audubon Primary Care Practice	21 Audubon Avenue	New York	NY	Active
DSH330101FA	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Dental Clinic	506 6th Street	Brooklyn	NY	Active
DSH330101FB	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - EP Lab	506 6th Street	Brooklyn	NY	Active
DSH330101FC	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Endoscopy	506 6th Street	Brooklyn	NY	Active
DSH330101FD	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Advanced Women's Imaging	506 6th Street	Brooklyn	NY	Active
DSH330101FE	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Nuclear Medicine	506 6th Street	Brooklyn	NY	Active
DSH330101FF	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Cardiothoracic OR	506 6th Street	Brooklyn	NY	Active
DSH330101FG	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Cardiac Cath Lab	506 6th Street	Brooklyn	NY	Active
DSH330101FH	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Emergency Department	506 6th Street	Brooklyn	NY	Active
DSH330101FJ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Breast Center	506 6th Sreet	Brooklyn	NY	Active
DSH330101FK	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	OB/GYN Women’s Health Clinic	263 7th Avenue	Brooklyn	NY	Active
DSH330101FL	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Outpatient Imaging Center	506 6th Street	Brooklyn	NY	Terminated
DSH330101FM	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Ambulatory Surgery	506 6th Street	Brooklyn	NY	Terminated
DSH330101FN	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Main Medicine Clinic	506 6th Street	Brooklyn	NY	Active
DSH330101FP	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Radiation Oncology	506 6th Street	Brooklyn	NY	Active
DSH330101FQ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Main Operating Rooms	506 6th Street	Brooklyn	NY	Active
DSH330101FR	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - PFT Lab	506 6th Street	Brooklyn	NY	Active
DSH330101FS	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - PACU	506 6th Street	Brooklyn	NY	Terminated
DSH330101FT	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Comprehensive Epilepsy Center	506 6th Street	Brooklyn	NY	Active
DSH330101FU	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Interventional Radiology - Interventional Radiology	506 6th Street	Brooklyn	NY	Active
DSH330101FV	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - Women's Diagnostic Center	506 6th Street	Brooklyn	NY	Active
DSH330101FW	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Brooklyn Methodist - MRI	506 6th Street	Brooklyn	NY	Active
DSH330101FX	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	BMH Pediatric Clinic	263 7th Avenue	Brooklyn	NY	Active
DSH330101FY	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CCH - Operating Rooms	515 6th Street	Brooklyn	NY	Active
DSH330101FZ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CCH - Ambulatory Services	515 6th Street	Brooklyn	NY	Active
DSH330101G	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Urgi Care Center	21 Audubon Avenue	New York	NY	Terminated
DSH330101GA	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CCH - Endoscopy and Special Procedures	515 6th Street	Brooklyn	NY	Active
DSH330101GB	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CCH - Pre-Anesthesia Evaluation Center	515 6th Street	Brooklyn	NY	Active
DSH330101GC	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CCH - Infusion Services	515 6th Street	Brooklyn	NY	Active
DSH330101GD	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CCH - Surgical Services	515 6th Street	Brooklyn	NY	Active
DSH330101GE	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Family PEACE Trauma Treatment Center - Peace Program	99 Fort Washington Ave	New York	NY	Active
DSH330101GF	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CCH - Medical Services	515 6th Street	Brooklyn	NY	Active
DSH330101GG	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CCH - Oncology Services	515 6th Street	Brooklyn	NY	Active
DSH330101GH	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW - Endoscopy	55 Palmer Ave	Bronxville	NY	Active
DSH330101GJ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	DHK - GI - Transplant	1283 York Avenue	New York	NY	Active
DSH330101GK	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	DHK - Main OR	1283 York Avenue	New York	NY	Active
DSH330101GL	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	HIP - Thyroid Clinic	161 Fort Washington Ave	New York	NY	Active
DSH330101GM	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	WBH - ECT	21 Bloomingdale Road	White Plains	NY	Active
DSH330101GN	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Allen - PFT Lab	5141 Broadway	New York	NY	Active
DSH330101GP	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	WBHC - Adult Psychiatric Clinic	21 Bloomingdale Road	White Plains	NY	Active
DSH330101GQ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	CCH - Diagnostic Imaging Center	515 6th Street	Brooklyn	NY	Active
DSH330101GR	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	NYPW - PFT Lab	55 Palmer Ave	Bronxville	NY	Active
DSH330101GS	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Milstein - X-Ray Imaging	177 Fort Washington Ave	New York	NY	Active
DSH330101GT	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Lower Manhattan Hospital - PFT Lab	170 William Street	New York	NY	Active
DSH330101GU	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Allen Hospital - Same Day Surgery	5141 Broadway	New York	NY	Terminated
DSH330101GV	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Avon - Breast Imaging Center	1130 St. Nicholas Ave	New York	NY	Active
DSH330101GW	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Heart Center - X-Ray Imaging	173 Fort Washington Ave	New York	NY	Active
DSH330101GX	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Westchester Behavioral Health Center - Adult Partial Hospital	21 Bloomingdale Road	White Plains	NY	Active
DSH330101GY	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Helmsley Medical Tower - Internal Medicine	505 East 70th St	New York	NY	Active
DSH330101GZ	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Presbyterian Hospital - Transfusion Medicine	622 West 168th Street	New York	NY	Approved
DSH330101H	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Broadway Practice	4781-83 Broadway	New York	NY	Active
DSH330101J	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Charles B. Rangel Community Center	534 West 135 Street	New York	NY	Active
DSH330101K	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Family Medicine at the Herman Denny Farrell, Jr. Community Health Center	610 West 158th Street	New York	NY	Active
DSH330101L	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Washington Heights Family Health Center	575 West 181 Street	New York	NY	Active
DSH330101M	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Center for Special Studies-Roger Unit	53 West 23rd Street	New York	NY	Active
DSH330101P	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Eye Institute- Operating Room	635 West 165th Street	New York	NY	Terminated
DSH330101Q	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	I. SHERWOOD WRIGHT CENTER FOR AGING	1484 1ST AVE	New York	NY	Terminated
DSH330101R	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	George Washington High School	549 Audubon Ave	New York	NY	Active
DSH330101S	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Intermediate School 143	515 West 182nd Street	New York	NY	Active
DSH330101T	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Intermediate School 164	401 West 164th Street	New York	NY	Active
DSH330101U	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Intermediate School 52	650 Academy Street	New York	NY	Active
DSH330101V	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Project Stay	622 West 168th Street	New York	NY	Terminated
DSH330101X	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Thurgood Marshall Academy	200-214 West 135th Street	New York	NY	Active
DSH330101Y	Child	DSH	NEW YORK-PRESBYTERIAN HOSPITAL	Intermediate School 136	6 Edgecombe Avenue	New York	NY	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		8/23/2024 3:15:34 PM	8/23/2024 3:15 PM
Details	State	Update		Approved	Active	10/1/2023 12:01 AM
Addresses	Main Address	Insert	New Registration		515 6th Street 2nd Floor Brooklyn, NY 11215	8/30/2023 7:53 AM
Addresses	Billing Address	Insert	New Registration		NewYork-Presbyterian Hospital 525 East 68th Street New York, NY 10065	8/30/2023 7:53 AM
Contacts	Signed By	Insert	New Registration		Farrell, William SVP, Finance New York Presbyterian 2122974358	8/30/2023 7:53 AM
Details	340B ID	Update	New Registration		DSH330101FZ	8/30/2023 7:53 AM
Details	Entity Name	Update	New Registration	NEW YORK PRESBYTERIAN HOSPITAL	NEW YORK-PRESBYTERIAN HOSPITAL	8/30/2023 7:53 AM
Details	Entity Subname	Update	New Registration	CCH Ambulatory Services	CCH - Ambulatory Services	8/30/2023 7:53 AM
Dates	Participating Approval Date	Update	New Registration		8/30/2023 7:53:25 AM	8/30/2023 7:53 AM
Details	State	Update	New Registration	Pending	Approved	8/30/2023 7:53 AM
Dates	Signed By Date	Update	New Registration		7/31/2023 3:36:56 PM	8/30/2023 7:53 AM
Dates	Start Date	Update	New Registration		10/1/2023 12:00:00 AM	8/30/2023 7:53 AM
Addresses	Main Address	Insert	New Registration		515 6th Street 2nd Floor Brooklyn, NY 11215	7/6/2023 1:45 PM
Addresses	Billing Address	Insert	New Registration		NewYork-Presbyterian Hospital 525 East 68th Street New York, NY 10065	7/6/2023 1:45 PM
Addresses	Shipping Address	Insert	New Registration		NewYork-Presbyterian Brooklyn Methodist Hospital Center for Community Health 515 Sixth St. 6th Floor - Pharmacy Brooklyn, NY 11215-3609	7/6/2023 1:45 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/6/2023 1:45 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02998658	7/6/2023 1:45 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	7/6/2023 1:45 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/6/2023 1:45 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		4152301	7/6/2023 1:45 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NJ	7/6/2023 1:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1952332801	7/6/2023 1:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	7/6/2023 1:45 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1952332801	7/6/2023 1:45 PM
Medicaid Billing	NPI: State	Insert	New Registration		NJ	7/6/2023 1:45 PM
Contacts	Primary Contact	Insert	New Registration		Gharia, Gajendra Director of Finance, Dept of 340B Programs NewYork-Presbyterian Hospital 2122974353	7/6/2023 1:45 PM
Contacts	Authorizing Official	Insert	New Registration		Farrell, William SVP, Finance New York Presbyterian 2122974358	7/6/2023 1:45 PM
Details	Assistance Received From Date	Insert	New Registration			7/6/2023 1:45 PM
Details	Assistance Received To Date	Insert	New Registration			7/6/2023 1:45 PM
Details	Last Recertification Date	Insert	New Registration			7/6/2023 1:45 PM
Details	Grant Number	Insert	New Registration			7/6/2023 1:45 PM
Details	340B ID	Insert	New Registration			7/6/2023 1:45 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/6/2023 1:45 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/6/2023 1:45 PM
Details	Medicare Provider Number	Insert	New Registration		330101	7/6/2023 1:45 PM
Details	Entity Name	Insert	New Registration		NEW YORK PRESBYTERIAN HOSPITAL	7/6/2023 1:45 PM
Details	NOFO Number	Insert	New Registration			7/6/2023 1:45 PM
Details	Program Code	Insert	New Registration		DSH	7/6/2023 1:45 PM
Details	Entity Subname	Insert	New Registration		CCH Ambulatory Services	7/6/2023 1:45 PM
Dates	Participating Approval Date	Insert	New Registration			7/6/2023 1:45 PM
Details	State	Insert	New Registration		Pending	7/6/2023 1:45 PM
Dates	Registration Date	Insert	New Registration		7/6/2023 1:45:13 PM	7/6/2023 1:45 PM
Dates	Signed By Date	Insert	New Registration			7/6/2023 1:45 PM
Dates	Start Date	Insert	New Registration			7/6/2023 1:45 PM
Terminations	Termination Comments	Insert	New Registration			7/6/2023 1:45 PM
Terminations	Termination Date	Insert	New Registration			7/6/2023 1:45 PM
Terminations	Termination Effective Date	Insert	New Registration			7/6/2023 1:45 PM
Terminations	Termination Reason	Insert	New Registration			7/6/2023 1:45 PM