NPIMap

Organization Active NPI

Saratoga Dermatology, PC

  • Dermatology Physician
  • Saratoga Springs, NY
National Provider Identifier
1124039607
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SARATOGA DERMATOLOGY, PC
Practice address
54 Seward St
Suite 3
Saratoga Springs, NY 12866-1143
Phone
(518) 581-2860
NPI assigned
Aug 10, 2006
Last updated
Jun 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Authorized official

Name
Jean C Buhac, MDNPI 1720098262
Title
President
Phone
(518) 581-2860

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

54 Seward St
Suite 3
Saratoga Springs, NY 12866-1143

Mailing address

54 Seward St
Suite 3
Saratoga Springs, NY 12866-1143
Phone (518) 581-2860

Other practice location 1

103 Sitterly Rd Ste 2700
Halfmoon, NY 12065-5644
Phone (518) 581-2860

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040615000674 NY Part B Supplier - Clinic/Group Practice 1759365026 Receives reassigned benefits from 8 practitioners
Practice locations: Halfmoon, NY; Saratoga Springs, NY

National Provider Directory

National Provider Directory

Locations

54 Seward St
Ste 3
Saratoga Springs, NY 12866
Phone (518) 581-2860

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1124039607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 SEWARD ST",
            "address_2": "SUITE 3",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661143",
            "telephone_number": "518-581-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 SEWARD ST",
            "address_2": "SUITE 3",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661143",
            "telephone_number": "518-581-2860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Sitterly Rd Ste 2700",
            "address_purpose": "LOCATION",
            "city": "Halfmoon",
            "state": "NY",
            "postal_code": "120655644",
            "country_code": "US",
            "telephone_number": "518-581-2860",
            "fax_number": "518-581-7358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SARATOGA DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "BUHAC",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-581-2860",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "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 Jun 22, 2023; 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.