NPIMap

Organization Active NPI

Community Care Physicians, PC

Doing business as CapitalCare Internal Medicine Balltown Road

  • Internal Medicine Physician
  • Schenectady, NY
National Provider Identifier
1104109065
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
154946 Issued in NY
Legal business name
COMMUNITY CARE PHYSICIANS, PC
Doing business as
CapitalCare Internal Medicine Balltown Road
Practice address
2546 Balltown Road
Suite 200
Schenectady, NY 12309-1079
Phone
(518) 374-1444
Fax
(518) 374-0491
NPI assigned
Sep 27, 2011
Last updated
Mar 14, 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 14, 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
Internal Medicine Physician 207R00000X 154946 NY Primary

Addresses

Primary practice location

2546 Balltown Road
Suite 200
Schenectady, NY 12309-1079

Mailing address

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

Other names 1

  • CapitalCare Internal Medicine Balltown Road Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1036199Capitalcare Internal Medicine Balltown Road2546 Balltown Road, Suite 200, Schenectady, NY 12309Certificate of waiverJun 30, 2027

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552521600000",
    "number": "1104109065",
    "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": "2546 BALLTOWN ROAD",
            "address_2": "SUITE 200",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123091079",
            "telephone_number": "518-374-1444",
            "fax_number": "518-374-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CARE PHYSICIANS, PC",
        "enumeration_date": "2011-09-27",
        "last_updated": "2019-03-14",
        "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": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "154946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CapitalCare Internal Medicine Balltown Road",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.