Active NPI
Stephen Michel Gagnon, PHARM.D.
- Pharmacist
- Clifton Park, NY
National Provider Identifier
1285956599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 053521
- Practice address
- 839 Route 146
Clifton Park, NY 12065-3861 - Phone
- (518) 371-3700
- Fax
- (518) 371-7103
- NPI assigned
- Mar 1, 2010
- Last updated
- Dec 12, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS49622 | FL | |
| Pharmacist | 183500000X | 053521 | NY | Primary |
Addresses
Primary practice location
839 Route 146
Clifton Park, NY 12065-3861
Mailing address
203 Vischer Ferry Rd
Rexford, NY 12148-1620
Phone (518) 727-7838
Other practice location 1
1706 US Highway 1
Vero Beach, FL 32960-5545
Phone (772) 567-7136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS49622 | FL | MD | Pharmacist |
| 053521 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany, L.L.C. | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670803200000",
"number": "1285956599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 VISCHER FERRY RD",
"city": "REXFORD",
"state": "NY",
"postal_code": "121481620",
"telephone_number": "518-727-7838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "839 ROUTE 146",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120653861",
"telephone_number": "518-371-3700",
"fax_number": "518-371-7103"
}
],
"practiceLocations": [
{
"address_1": "1706 US Highway 1",
"address_purpose": "LOCATION",
"city": "Vero Beach",
"state": "FL",
"postal_code": "329605545",
"country_code": "US",
"telephone_number": "772-567-7136",
"fax_number": "772-778-6536",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAGNON",
"first_name": "STEPHEN",
"middle_name": "MICHEL",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-01",
"last_updated": "2022-12-12",
"certification_date": "2021-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS49622",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "053521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.