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CONIFER PARK, INC.
NPI 1366498768
Clinic/Center - Rehabilitation, Substance Use Disorder in Liverpool, NY

Active since May 26, 2006CLIA 33D2028444 · Waiver
526 OLD LIVERPOOL RD, LIVERPOOL, NY 13088(315) 453-3911(315) 453-0197 Get Directions Write a Review

NPPES record last updated: April 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 29, 2021, Jan 30, 2017 (2 updates tracked since 2017).

About Conifer Park, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONIFER PARK, INC. (NPI 1366498768) is a healthcare organization registered as a rehabilitation, substance use disorder in Liverpool, New York and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Tammy Smith, Director, Op Billing Dept, as its authorized official.

NPPES Registry Identity

NPI1366498768
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameCONIFER PARK, INC.
Location Address526 OLD LIVERPOOL RDLiverpool, NY 13088-6238
Mailing AddressPo Box 10092Albany, NY 12201-5092 · (518) 952-8408 · Fax (518) 399-6860
Phone(315) 453-3911
Fax(315) 453-0197
Organization SubpartNo
Authorized OfficialTammy SmithDirector, Op Billing Dept · (518) 952-8408
Enumeration DateMay 26, 2006
Last NPPES UpdateApril 29, 20212 updates tracked since enumeration
NPPES CertifiedApril 29, 2021
✔ NPI 1366498768 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
526 OLD LIVERPOOL RD, Liverpool, NY 13088
Open in Google Maps ↗

Other Identifiers 1

Medicaid01420800NY

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2028444

Conifer Park - Liverpool Opc · Liverpool, NY
Active · expires Mar 26, 2027
CLIA Number33D2028444
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateAugust 17, 2011
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. George A. Disney
Laboratory Phone(315) 453-3911
Laboratory LocationConifer Park - Liverpool Opc526 Old Liverpool Rd - Suite 4, Liverpool, NY 13088
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm G2067
Medication Assisted Treatment (MAT) with methadone is a comprehensive approach to manage opioid addiction. It includes weekly methadone dispensing, substance use counseling, individual and group therapy sessions, and toxicology tests as needed, all provided by a Medicare-enrolled opioid treatment program.
196 services11 patients
Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure G2078
This service provides an additional 7-day supply of methadone, a medication used to treat opioid addiction, for patients to take at home. It's provided by a Medicare-enrolled opioid treatment program. This service is billed separately from the main treatment procedure.
185 services11 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL ALLEN ANDERS DPT
Physical Therapist (Orthopedic)
526 OLD LIVERPOOL RD, SUITE 4
LIVERPOOL, NY 13088
Onondaga County (315) 457-7005
ADAM SIEGEL
Counselor (Addiction (Substance Use Disorder))
526 OLD LIVERPOOL RD
LIVERPOOL, NY 13088
Onondaga County (315) 453-3911
MRS. MALISSA ELIZABETH O'CONNOR LPN
Licensed Practical Nurse
526 OLD LIVERPOOL RD
LIVERPOOL, NY 13088
Onondaga County (315) 453-5537
LESLIE WOODWARD
Counselor (Addiction (Substance Use Disorder))
526 OLD LIVERPOOL RD
LIVERPOOL, NY 13088
Onondaga County (315) 453-3911
SARA L DIONNE RN
Registered Nurse (Psychiatric/Mental Health, Child & Adolescent)
526 OLD LIVERPOOL RD
LIVERPOOL, NY 13088
Onondaga County (315) 453-3911
PETER CUSIMANO PT
Physical Therapist
526 OLD LIVERPOOL RD
LIVERPOOL, NY 13088
Onondaga County (315) 457-7005
COLLEEN M DAVIS LPN
Licensed Practical Nurse
526 OLD LIVERPOOL RD
LIVERPOOL, NY 13088
Onondaga County (315) 453-3911
COLLEEN CALLAGHAN-KIRKLAND CASAC
Counselor (Addiction (Substance Use Disorder))
526 OLD LIVERPOOL RD
LIVERPOOL, NY 13088
Onondaga County (315) 453-3911

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Conifer Park, Inc.'s NPI number?

The NPI number for Conifer Park, Inc. is 1366498768. It was assigned to this organization in the NPPES registry on May 26, 2006.

Where is Conifer Park, Inc. located?

Conifer Park, Inc. is located at 526 Old Liverpool Rd, Liverpool, NY 13088. The listed phone number is (315) 453-3911.

What is Conifer Park, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Does Conifer Park, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2028444) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Conifer Park, Inc. was last updated on April 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.