Monticello Family Medicine & Walk-in Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

229335 Issued in NY

Legal business name

MONTICELLO FAMILY MEDICINE & WALK-IN CENTER

Practice address

10 Prince St Ste 7
Monticello, NY 12701-1919

Phone

(845) 794-7943

Fax

(845) 791-8101

NPI assigned

Dec 1, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Robin A Decaro

Title

Billing Manager

Phone

(845) 856-4936

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228953600000",
    "number": "1053566232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 UPPER PINEKILL RD",
            "city": "WESTBROOKVILLE",
            "state": "NY",
            "postal_code": "12785",
            "telephone_number": "845-794-7943",
            "fax_number": "845-791-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PRINCE ST STE 7",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127011919",
            "telephone_number": "845-794-7943",
            "fax_number": "845-791-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO FAMILY MEDICINE & WALK-IN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-11",
        "status": "A",
        "authorized_official_last_name": "DECARO",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "845-856-4936",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "229335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02614639",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roberta Mitchell-Krebs
• Mahrous Mohamed, DPT
• Brij Mohan, M.D.
• Wanda Monroe
• Monticello Central School District
• Monticello Pharmacy, Inc.
• Montrose Vamc
• Ronda Ginean Moore-Watson, LPN
• Tamika Moore, RN
• Kelly Moorer

• Family Medicine Physician in Monticello, NY
• Providers in Monticello, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.