Organization Active NPI

Immediate Medical Care Associates, PLLC

  • Emergency Care Clinic/Center
  • Camillus, NY
National Provider Identifier
1083698377
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
IMMEDIATE MEDICAL CARE ASSOCIATES, PLLC
Practice address
5700 W Genesee St
Suite 100 South
Camillus, NY 13031-3200
Phone
(315) 488-6393
Fax
(315) 488-5854
NPI assigned
Dec 1, 2005
Last updated
Dec 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Authorized official

Name
Alan Mancusi-Ungaro, M.D.NPI 1437239290
Title
Senior Partner
Phone
(315) 488-6393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X NU Primary

Addresses

Primary practice location

5700 W Genesee St
Suite 100 South
Camillus, NY 13031-3200

Mailing address

5700 W Genesee St
Suite 100 South
Camillus, NY 13031-3200
Phone (315) 488-6393

Other identifiers 2

IdentifierTypeStateIssuer
930066333OtherNYMEDICARE RAILROAD
930066334OtherNYMEDICARE RAILROAD

National Provider Directory

National Provider Directory

Locations

5700 W Genesee St
Ste 100
Camillus, NY 13031
Phone (315) 487-5337

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1083698377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST",
            "address_2": "SUITE 100 SOUTH",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313200",
            "telephone_number": "315-488-6393",
            "fax_number": "315-488-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W GENESEE ST",
            "address_2": "SUITE 100 SOUTH",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130313200",
            "telephone_number": "315-488-6393",
            "fax_number": "315-488-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDIATE MEDICAL CARE ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "MANCUSI-UNGARO",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "315-488-6393",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "930066333",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "930066334",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.