NPIMap

Organization Active NPI

Community Care Physicians, PC

Doing business as The Office of Marino Baselice

  • Internal Medicine Physician
  • Delmar, NY
National Provider Identifier
1285905786
Registry record updated Jan 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
134658 Issued in NY
Legal business name
COMMUNITY CARE PHYSICIANS, PC
Doing business as
The Office of Marino Baselice
Practice address
199 Delaware Ave
Delmar, NY 12054-1229
Phone
(518) 439-1131
Fax
(518) 439-6306
NPI assigned
Jan 16, 2012
Last updated
Jan 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2012

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

Authorized official

Name
Diane M Stamas
Title
Senior Credentialing Coordinator
Phone
(518) 782-3742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 134658 NY Primary

Addresses

Primary practice location

199 Delaware Ave
Delmar, NY 12054-1229

Mailing address

711 Troy Schenectady Rd
Suite 203
Latham, NY 12110-2442
Phone (518) 782-3700

Other names 1

  • The Office of Marino Baselice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Deborah Aberdale NP121 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 6

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": "1326672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326672000000",
    "number": "1285905786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 DELAWARE AVE",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541229",
            "telephone_number": "518-439-1131",
            "fax_number": "518-439-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-16",
        "last_updated": "2012-01-16",
        "status": "A",
        "authorized_official_last_name": "STAMAS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "518-782-3742"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "134658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Office of Marino Baselice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delmar, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.