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MEDICAL SERVICES OF KIPS BAY, P.C.

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Company Details

Name: MEDICAL SERVICES OF KIPS BAY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 11 Sep 2020 (5 years ago)
Entity Number: 5833386
ZIP code: 11042
County: Nassau
Place of Formation: New York
Address: ATTN: OFFICE OF LEGAL AFFAIRS, 2000 MARCUS AVENUE, NEW HYDE PARK, NY, United States, 11042

Contact Details

Phone +1 516-396-7846

Phone +1 516-321-7555

Phone +1 516-487-4464

Phone +1 631-470-8379

Shares Details

Shares issued 100

Share Par Value 1

Type PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent ATTN: OFFICE OF LEGAL AFFAIRS, 2000 MARCUS AVENUE, NEW HYDE PARK, NY, United States, 11042

National Provider Identifier

NPI Number:
1669075651
Certification Date:
2022-10-06

Authorized Person:

Name:
MRS. MICHELE L CUSACK
Role:
SENIOR VICE PRESIDENT & CFO
Phone:

Taxonomy:

Selected Taxonomy:
207RA0401X - Addiction Medicine (Internal Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
No
Selected Taxonomy:
207RI0011X - Interventional Cardiology Physician
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
2084N0400X - Neurology Physician
Is Primary:
Yes

Contacts:

Fax:
6316541474
Fax:
5164874980

History

Start date End date Type Value
2021-11-17 2025-04-22 Shares Share type: PAR VALUE, Number of shares: 100, Par value: 1
2021-11-17 2025-04-22 Address ATTN: OFFICE OF LEGAL AFFAIRS, 2000 MARCUS AVENUE, NEW HYDE PARK, NY, 11042, USA (Type of address: Service of Process)
2020-09-11 2021-11-17 Shares Share type: PAR VALUE, Number of shares: 100, Par value: 1
2020-09-11 2021-11-17 Address ATTN: OFFICE OF LEGAL AFFAIRS, 2000 MARCUS AVENUE, NEW HYDE PARK, NY, 11042, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
250422002476 2025-04-22 BIENNIAL STATEMENT 2025-04-22
211117000638 2021-11-17 CERTIFICATE OF AMENDMENT 2021-11-17
200911000325 2020-09-11 CERTIFICATE OF INCORPORATION 2020-09-11

Tax Exempt

Employer Identification Number (EIN) :
85-3052457
In Care Of Name:
% NORTHWELL HEALTH INC
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
2022-08
National Taxonomy Of Exempt Entities:
Health Care: Health Treatment Facilities, Primarily Outpatient
Deductibility:
Type of organization and use of contribution: A Type I, Type II, or functionally integrated Type III supporting organization. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State