NPIMap

Organization Active NPI

Primary Care Health Partners - New York LLP

  • Family Medicine Physician
  • Plattsburgh, NY
National Provider Identifier
1003861782
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY CARE HEALTH PARTNERS - NEW YORK LLP
Practice address
159 Margaret St
Plattsburgh, NY 12901-1893
Phone
(518) 562-0151
NPI assigned
May 23, 2006
Last updated
Jun 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jon W Asselin
Title
Coo
Phone
(802) 872-4326

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Pediatrics Physician 208000000X

Addresses

Primary practice location

159 Margaret St
Plattsburgh, NY 12901-1893

Mailing address

600 Blair Park Rd Ste 285
Williston, VT 05495-7586
Phone (802) 288-1140

Other identifiers 1

IdentifierTypeStateIssuer
02052362MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302000073 NY Part B Supplier - Clinic/Group Practice 5890682231 Receives reassigned benefits from 3 practitioners
Practice locations: Plattsburgh, NY

National Provider Directory

National Provider Directory
Tax ID family
Hoosick Falls Family Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

140 Main St
Hoosick Falls, NY 12090
Phone (518) 686-4337

Practitioners & affiliated clinicians

Practitioners 102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 102

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1003861782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BLAIR PARK RD STE 285",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957586",
            "telephone_number": "802-288-1140",
            "fax_number": "802-288-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 MARGARET ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011893",
            "telephone_number": "518-562-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE HEALTH PARTNERS - NEW YORK LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "ASSELIN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "802-872-4326"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02052362",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.