NPIMap

Organization Active NPI

Family Care Medical Group PC

Doing business as My Care

  • Non-Pharmacy Dispensing Site
  • Syracuse, NY
National Provider Identifier
1205237914
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
206570 Issued in NY
Legal business name
FAMILY CARE MEDICAL GROUP PC
Doing business as
My Care
Practice address
1304 Buckley Rd
Suite 302
Syracuse, NY 13212-4311
Phone
(315) 671-5790
NPI assigned
Sep 12, 2014
Last updated
Sep 12, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 206570 NY Primary

Addresses

Primary practice location

1304 Buckley Rd
Suite 302
Syracuse, NY 13212-4311

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • My Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Familycare Medical Grou6 organizations share this tax ID, including this one
Part of
Hamot Health Foundation

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410480000000",
    "number": "1205237914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 BUCKLEY RD",
            "address_2": "SUITE 302",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124311",
            "telephone_number": "315-671-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE MEDICAL GROUP PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC",
        "enumeration_date": "2014-09-12",
        "last_updated": "2014-09-12",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NY",
            "license": "206570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.