NPIMap

Organization Active NPI

Saratoga Regional Medical , P.C

  • Primary Care Clinic/Center
  • Saratoga Springs, NY
National Provider Identifier
1043891096
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SARATOGA REGIONAL MEDICAL , P.C
Practice address
15 Maple Dell Ste 1
Saratoga Springs, NY 12866-2953
Phone
(518) 886-5112
Fax
(518) 886-5880
NPI assigned
Apr 20, 2021
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SARATOGA REGIONAL MEDICAL , P.CAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Christopher Jenkins
Title
Director
Phone
(518) 583-8346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

15 Maple Dell Ste 1
Saratoga Springs, NY 12866-2953

Mailing address

PO Box 412655
Boston, MA 02241-2655

Other practice location 1

267 Union Ave
Saratoga Springs, NY 12866-3533
Phone (518) 886-5970

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150505002182 NY Part B Supplier - Clinic/Group Practice 9032438544 Receives reassigned benefits from 137 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saratoga Springs, NY; Queensbury, NY; Plattsburgh, NY; Malta, NY; Ballston Spa, NY

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Saratoga Regional Medical

Practitioners & affiliated clinicians

Practitioners 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1043891096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412655",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MAPLE DELL STE 1",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128662953",
            "telephone_number": "518-886-5112",
            "fax_number": "518-886-5880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "267 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128663533",
            "country_code": "US",
            "telephone_number": "518-886-5970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SARATOGA REGIONAL MEDICAL , P.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SARATOGA REGIONAL MEDICAL , P.C",
        "enumeration_date": "2021-04-20",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "518-583-8346"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.