CONIFER PARK, INC.
NPI 1972558179
Clinic/Center - Rehabilitation, Substance Use Disorder in Glens Falls, NY

Active since May 24, 2006CLIA 33D2028443 · Waiver
55 ELM ST, GLENS FALLS, NY 12801(518) 793-7273(518) 798-5004 Get Directions Write a Review

NPPES record last updated: April 29, 2021. Verified against the NPPES registry weekly; last sync: October 18, 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 1972558179) is a healthcare organization registered as a rehabilitation, substance use disorder in Glens Falls, 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, Dir, Op Billing Dept, as its authorized official.

NPPES Registry Identity

NPI1972558179
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameCONIFER PARK, INC.
Location Address55 ELM STGlens Falls, NY 12801-3549
Mailing AddressPo Box 10092Albany, NY 12201-5092 · (518) 952-8408 · Fax (518) 399-6860
Fax(518) 798-5004
Organization SubpartNo
Authorized OfficialTammy SmithDir, Op Billing Dept · (518) 952-8408
Enumeration DateMay 24, 2006
Last NPPES UpdateApril 29, 20212 updates tracked since enumeration
NPPES CertifiedApril 29, 2021
✔ NPI 1972558179 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
55 ELM ST, Glens Falls, NY 12801

Other Identifiers 1

Medicaid01420800NY

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Conifer Park, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

15

Medicare enrollment records show 15 clinicians reassign Medicare billing to Conifer Park, Inc., which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians by Medicare Specialty 5

Nurse Practitioner9
Clinical Social Worker2
Mental Health Counselor2
Family Practice1
Internal Medicine1

Clinicians, nearest first (15)

Clinical Social Worker
NPI 1598787095
79 GLENRIDGE RD
Glenville, NY 12302
(518) 952-8335
✔ PECOS33 mi
Nurse Practitioner
NPI 1942841242
2 GUY PARK AVE STE 109
Amsterdam, NY 12010
(518) 944-4718
✔ PECOS✔ Accepts Medicare36 mi
Nurse Practitioner
NPI 1609612472
600 FRANKLIN ST STE 204
Schenectady, NY 12305
(518) 372-7031
✔ PECOS✔ Accepts Medicare37 mi
Mental Health Counselor
NPI 1689189219
2435 6TH AVE
Troy, NY 12180
(518) 274-5143
✔ PECOS✔ Accepts Medicare39 mi
Nurse Practitioner
NPI 1942527783
2435 6TH AVE
Troy, NY 12180
(518) 274-5143
✔ PECOS✔ Accepts Medicare39 mi
Clinical Social Worker
NPI 1528675576
315 S MANNING BLVD
Albany, NY 12208
(518) 603-5207
✔ PECOS46 mi
Nurse Practitioner
NPI 1548890841
80 SHARRON AVE
Plattsburgh, NY 12901
(518) 561-1447
✔ PECOS✔ Accepts Medicare95 mi
Mental Health Counselor
NPI 1740725050
80 SHARRON AVE
Plattsburgh, NY 12901
(518) 561-1447
✔ PECOS✔ Accepts Medicare95 mi
Family Practice
NPI 1588614275
159 MARGARET ST SUITE 101
Plattsburgh, NY 12901
(518) 314-3939
✔ PECOS✔ Accepts Medicare96 mi
Nurse Practitioner
NPI 1396882312
40 JON BARRETT RD
Patterson, NY 12563
(845) 878-9078
✔ PECOS127 mi
Nurse Practitioner
NPI 1245452119
526 OLD LIVERPOOL RD
Liverpool, NY 13088
(315) 453-3911
✔ PECOS129 mi
Nurse Practitioner
NPI 1073310728
21 BLOOMINGDALE RD
White Plains, NY 10605
(917) 547-9999
✔ PECOS✔ Accepts Medicare158 mi
Internal Medicine
NPI 1154349447
266 W 37TH ST 12TH FLOOR
New York, NY 10018
(212) 947-8522
✔ PECOS177 mi
Nurse Practitioner
NPI 1275091266
556 CLINTON AVE S
Rochester, NY 14620
(585) 442-8422
✔ PECOS✔ Accepts Medicare200 mi
Nurse Practitioner
NPI 1407089212
70 W LUCERNE CIR FL TS
Orlando, FL 32801
(877) 279-5960
✔ PECOS✔ Accepts Medicare1,106 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 33D2028443

Conifer Park - Glens Falls Opc · Glens Falls, NY
Active · expires Mar 26, 2027
CLIA Number33D2028443
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateAugust 17, 2011
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. George A. Disney
Laboratory Phone(518) 793-7273
Laboratory LocationConifer Park - Glens Falls Opc55 Elm Street, Glens Falls, NY 12801
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1972558179. It was assigned to this organization in the NPPES registry on May 24, 2006.

Where is Conifer Park, Inc. located?

Conifer Park, Inc. is located at 55 Elm St, Glens Falls, NY 12801. The listed phone number is (518) 793-7273.

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.

Is Conifer Park, Inc. enrolled in Medicare?

Yes. Conifer Park, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Conifer Park, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 5 Medicare specialties reassign their Medicare billing to Conifer Park, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (9), Clinical Social Worker (2) and Mental Health Counselor (2). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Yes. A Certificate of Waiver (number 33D2028443) 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.