Active NPI
Port City Family Medicine P.C. Inc
- Family Medicine Physician
- Oswego, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- PORT CITY FAMILY MEDICINE P.C. INC
- Practice address
- 33 E Schuyler St
Oswego, NY 13126-1161 - Phone
- (315) 343-6974
- Fax
- (315) 342-3625
- NPI assigned
- Sep 27, 2006
- Last updated
- Mar 15, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Corliss Adam Varnum, M.D.
- Title
- President
- Phone
- (315) 343-6974
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Pediatrics Physician | 208000000X |
Addresses
Primary practice location
33 E Schuyler St
Oswego, NY 13126-1161
Mailing address
33 E Schuyler St
Oswego, NY 13126-1161
Phone (315) 343-6974
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0165866 | Port City Family Medicine PC | Provider-performed microscopy | Jan 25, 2027 |
National Provider Directory
National Provider DirectoryLocations
200 Corporate Plz
#A103
Islandia, NY 11749
Phone (631) 234-2828
209 W 7th St
Oswego, NY 13126
Phone (315) 343-6974
33 E Schuyler St
Oswego, NY 13126
Phone (315) 342-2024
Practitioners & affiliated clinicians
Practitioners 9
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.
-
- Family Nurse Practitioner
- Oswego, NY
- NPI 1598595480
-
- Family Medicine Physician
- Oswego, NY
- NPI 1942290358
-
- Internal Medicine Physician
- Oswego, NY
- NPI 1245220656
-
- Medical Physician Assistant
- Cortland, NY
- NPI 1417366642
-
- Family Medicine Physician
- Oswego, NY
- NPI 1275523672
-
- Mental Health Counselor
- Oswego, NY
- NPI 1932773454
-
- Optometrist
- Auburn, NY
- NPI 1942278239
-
- Ophthalmology Physician
- Oswego, NY
- NPI 1093751901
-
- Diagnostic Radiology Physician
- Clearwater, FL
- NPI 1063466183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1552608000000",
"number": "1215028055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 E SCHUYLER ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131261161",
"telephone_number": "315-343-6974",
"fax_number": "315-342-3625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 E SCHUYLER ST",
"city": "OSWEGO",
"state": "NY",
"postal_code": "131261161",
"telephone_number": "315-343-6974",
"fax_number": "315-342-3625"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PORT CITY FAMILY MEDICINE P.C. INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-27",
"last_updated": "2019-03-15",
"status": "A",
"authorized_official_last_name": "VARNUM",
"authorized_official_first_name": "CORLISS",
"authorized_official_middle_name": "ADAM",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "315-343-6974",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.