NPIMap

Organization Active NPI

Hudson Mohawk Pediatrics

  • Children's Hospital
  • Ballston Lake, NY
National Provider Identifier
1225393986
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
107075 Issued in NY
Legal business name
HUDSON MOHAWK PEDIATRICS
Practice address
318 Ruhle Rd S
Ballston Lake, NY 12019-1030
Phone
(518) 899-4133
NPI assigned
Jul 9, 2012
Last updated
Jul 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Authorized official

Name
Dr. Gayle BuckleyNPI 1972587681
Title
Owner
Phone
(518) 899-4133

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
Children's Hospital 282NC2000X 107075 NY Primary

Addresses

Primary practice location

318 Ruhle Rd S
Ballston Lake, NY 12019-1030

Mailing address

318 Ruhle Rd S
Ballston Lake, NY 12019-1030
Phone (518) 899-4133

Other identifiers 1

IdentifierTypeStateIssuer
00628079MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1341792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341792000000",
    "number": "1225393986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 RUHLE RD S",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191030",
            "telephone_number": "518-899-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 RUHLE RD S",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191030",
            "telephone_number": "518-899-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON MOHAWK PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-899-4133",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "NY",
            "license": "107075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00628079",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.