NPIMap

Organization Active NPI

Capital Region Primary Care PLLC

  • Family Medicine Physician
  • Malta, NY
National Provider Identifier
1164864641
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAPITAL REGION PRIMARY CARE PLLC
Practice address
2537 Route 9
Malta, NY 12020-4328
Phone
(518) 289-2400
Fax
(518) 289-2410
NPI assigned
Jul 24, 2013
Organization subpart
Yes
Parent organization
ELLIS HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Authorized official

Name
David Liebers, MDNPI 1245234905
Title
Medical Director
Phone
(518) 243-4134

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
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2537 Route 9
Malta, NY 12020-4328

Mailing address

PO Box 11226
Albany, NY 12211-0226
Phone (518) 389-1725

National Provider Directory

National Provider Directory
Part of
Edward W Doucet MD

Locations

2537 State Route 9
Malta, NY 12020
Phone (518) 289-2400

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391644800000",
    "number": "1164864641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11226",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122110226",
            "telephone_number": "518-389-1725",
            "fax_number": "518-389-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 ROUTE 9",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204328",
            "telephone_number": "518-289-2400",
            "fax_number": "518-289-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION PRIMARY CARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIS HOSPITAL",
        "enumeration_date": "2013-07-24",
        "last_updated": "2014-02-06",
        "status": "A",
        "authorized_official_last_name": "LIEBERS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "518-243-4134",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.