NPIMap

Organization Active NPI

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

Doing business as Northeast Advance Imaging, P.C.

  • Diagnostic Radiology Physician
  • Albany, NY
National Provider Identifier
1134348170
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
54964 Issued in NY
Legal business name
PRIME CARE PHYSICIANS, P.L.L.C.
Doing business as
Northeast Advance Imaging, P.C.
Practice address
315 S Manning Blvd
Medical Imaging Department
Albany, NY 12208-1707
Phone
(518) 525-1852
Fax
(518) 525-5187
NPI assigned
Apr 25, 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
Title
Director of Administration
Phone
(518) 435-2704

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0700X 54964 NY
Nuclear Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0904X 54964 NY
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 54964 NY Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X 54964 NY
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X 54964 NY

Addresses

Primary practice location

315 S Manning Blvd
Medical Imaging Department
Albany, NY 12208-1707

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
02616571MedicaidNY

Other names 1

  • Northeast Advance Imaging, P.C. Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1134348170",
    "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": "315 S MANNING BLVD",
            "address_2": "MEDICAL IMAGING DEPARTMENT",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1852",
            "fax_number": "518-525-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE PHYSICIANS, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "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."
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "54964",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NY",
            "license": "54964",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "54964",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "54964",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "54964",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02616571",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Advance Imaging, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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.