NPIMap

Individual provider Active NPI

Edgar C Elum, MD

  • Internal Medicine Physician
  • Albany, NY
National Provider Identifier
1184601692
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
111259 Issued in NY
Practice address
1662 Central Ave
Albany, NY 12205
Phone
(518) 869-9692
Fax
(518) 869-7220
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 111259 NY Primary

Addresses

Primary practice location

1662 Central Ave
Albany, NY 12205

Mailing address

1662 Central Ave
Albany, NY 12205
Phone (518) 869-9692

Other identifiers 15

IdentifierTypeStateIssuer
000411153008OtherBLUE SHIELD OF NENY
10000574OtherCDPHP
11742OtherMVP
2594608OtherGHI
115780OtherMVP
141752151OtherUNITED HEALTH CARE
000411153007OtherBLUE SHIELD OF NENY
141659448OtherSTATEWIDE PPO
24S111OtherBLUE CROSS BLUE SHIELD
55333OtherGHI HMO
141659448OtherUNITED HEALTH CARE
141752151OtherSTATEWIDE PPO
24S113OtherBLUE CROSS BLUE SHIELD
24S112OtherBLUE CROSS BLUE SHIELD
4396748OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
R.G. Psychological Services, P.C. Past Accepting new patients
Nebres & Patel LLP Internal Medicine Past Accepting new patients
Hospitalist Healthcare Services PLLC Internal Medicine Past Accepting new patients
Capital District Metropolitan Medical Assoc PC Internal Medicine Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1184601692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1662 CENTRAL AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12205",
            "telephone_number": "518-869-9692",
            "fax_number": "518-869-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1662 CENTRAL AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12205",
            "telephone_number": "518-869-9692",
            "fax_number": "518-869-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELUM",
        "first_name": "EDGAR",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "111259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NENY",
            "identifier": "000411153008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10000574",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "11742",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2594608",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "115780",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "141752151",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NENY",
            "identifier": "000411153007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATEWIDE PPO",
            "identifier": "141659448",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "24S111",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "55333",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "141659448",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATEWIDE PPO",
            "identifier": "141752151",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "24S113",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "24S112",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4396748",
            "state": null
        }
    ],
    "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 Sep 28, 2011; 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.