NPIMap

Organization Active NPI

Prime Care Physicians, P.L.L.C.

  • Internal Medicine Physician
  • Albany, NY
National Provider Identifier
1124248430
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIME CARE PHYSICIANS, P.L.L.C.
Practice address
63 Albany Shaker Road
Suite 102
Albany, NY 12204
Phone
(518) 207-2710
Fax
(518) 207-2713
NPI assigned
Apr 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Authorized official

Name
Mr. Michael Whalen II
Title
Director of Administration
Phone
(518) 435-2704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X NY Primary

Addresses

Primary practice location

63 Albany Shaker Road
Suite 102
Albany, NY 12204

Mailing address

4 Atrium Dr
Suite 100
Albany, NY 12205-1441
Phone (518) 435-2704

Other identifiers 1

IdentifierTypeStateIssuer
02616571MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1124248430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ATRIUM DR",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051441",
            "telephone_number": "518-435-2704",
            "fax_number": "518-458-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 ALBANY SHAKER ROAD",
            "address_2": "SUITE 102",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12204",
            "telephone_number": "518-207-2710",
            "fax_number": "518-207-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE PHYSICIANS, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "WHALEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "518-435-2704",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02616571",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.