NPIMap

Organization Active NPI

Community Care Physicians, PC

Doing business as ImageCare Guilderland

  • Diagnostic Radiology Physician
  • Guilderland, NY
National Provider Identifier
1073760385
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
176417 Issued in NY
Legal business name
COMMUNITY CARE PHYSICIANS, PC
Doing business as
ImageCare Guilderland
Practice address
3757 Carman Rd
Suite 102
Guilderland, NY 12303
Phone
(518) 881-1188
Fax
(518) 881-1192
NPI assigned
Aug 19, 2008
Last updated
Mar 15, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY CARE PHYSICIANS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Authorized official

Name
Debby Coons
Title
Credentialing Manager
Phone
(518) 213-0478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 176417 NY Primary

Addresses

Primary practice location

3757 Carman Rd
Suite 102
Guilderland, NY 12303

Mailing address

711 Troy Schenectady Rd Ste 203
Latham, NY 12110-2461
Phone (518) 782-3700

Other identifiers 1

IdentifierTypeStateIssuer
01322398MedicaidNY

Other names 1

  • ImageCare Guilderland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kevin Lau MD121 organizations share this tax ID, including this one
Part of
Kevin Lau MD

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552608000000",
    "number": "1073760385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3757 CARMAN RD",
            "address_2": "SUITE 102",
            "city": "GUILDERLAND",
            "state": "NY",
            "postal_code": "12303",
            "telephone_number": "518-881-1188",
            "fax_number": "518-881-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CARE PHYSICIANS, PC",
        "enumeration_date": "2008-08-19",
        "last_updated": "2019-03-15",
        "status": "A",
        "authorized_official_last_name": "COONS",
        "authorized_official_first_name": "DEBBY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-213-0478"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "176417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01322398",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ImageCare Guilderland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guilderland, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.