NPIMap

Organization Active NPI

Adirondack Medical Center

  • General Practice Physician
  • Saranac Lake, NY
National Provider Identifier
1245446533
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ADIRONDACK MEDICAL CENTER
Practice address
2233 State Route 86
Saranac Lake, NY 12983-5644
Phone
(518) 891-4141
Fax
(518) 897-2423
NPI assigned
May 15, 2007
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Adele Pickreign
Title
Credentialing Coordinator
Phone
(518) 897-4725

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU
Surgical Physician Assistant 363AS0400X NU
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Clinical Social Worker 1041C0700X NU
Internal Medicine Physician 207R00000X NU
Neurology Physician 2084N0400X NU
Surgery Physician 208600000X NU
Urology Physician 208800000X NU
General Practice Physician 208D00000X NU Primary
Pediatric Orthopaedic Surgery Physician 207XP3100X NU
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X NU
Psychosomatic Medicine Physician 2084P0015X NU
Prescribing (Medical) Psychologist 103TP0016X NU

Addresses

Primary practice location

2233 State Route 86
Saranac Lake, NY 12983-5644

Mailing address

PO Box 1380
Attn: Provider Enrollment
Saranac Lake, NY 12983
Phone (518) 897-4725

Other identifiers 1

IdentifierTypeStateIssuer
00363213MedicaidNY

Other names 1

  • Adirondack Medical Center - Physician Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000224 NY Part B Supplier - Clinic/Group Practice 9638081284 Receives reassigned benefits from 95 practitioners
1 other NPI on this enrollment
Practice locations: Saint Regis Falls, NY; Tupper Lake, NY; Saranac Lake, NY; Plattsburgh, NY; Lake Placid, NY; Keene, NY

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2249 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-3845

Practitioners & affiliated clinicians

Practitioners 101

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.

View all 101

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1245446533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1380",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "12983",
            "telephone_number": "518-897-4725",
            "fax_number": "518-897-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 STATE ROUTE 86",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835644",
            "telephone_number": "518-891-4141",
            "fax_number": "518-897-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADIRONDACK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "PICKREIGN",
        "authorized_official_first_name": "ADELE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "518-897-4725"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00363213",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adirondack Medical Center - Physician",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Adirondack Medical Center - Physician",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saranac Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.