Adirondack Healthcare Associates, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

162323-1 Issued in NY

Legal business name

ADIRONDACK HEALTHCARE ASSOCIATES, LLC

Practice address

3384 State Route 22
Peru, NY 12972-5305

Phone

(518) 643-8008

Fax

(518) 643-8090

NPI assigned

Jul 26, 2006

Last updated

Dec 3, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy J McDonald

Title

Office Manager

Phone

(518) 643-8008

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Richard Jensen

  • Physician Assistant
  • Peru, NY
  • NPI 1417963588
  NPD (past)
• Wallace M Handeland, O.D.

  • Optometrist
  • Virginia Beach, VA
  • NPI 1598740581
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1306869672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3384 STATE ROUTE 22",
            "city": "PERU",
            "state": "NY",
            "postal_code": "129725305",
            "telephone_number": "518-643-8008",
            "fax_number": "518-643-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3384 STATE ROUTE 22",
            "city": "PERU",
            "state": "NY",
            "postal_code": "129725305",
            "telephone_number": "518-643-8008",
            "fax_number": "518-643-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADIRONDACK HEALTHCARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "518-643-8008"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "162323-1",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "006858-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F331788",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP GROUP NUMBER",
            "identifier": "8527",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adirondack Medical Practice LLC
• Elizabeth Rose Ahern, RPA-C
• Laura Elizabeth Allen, REGISTERED NURSE
• Mary Ames, R.N.
• Joy Arana, LCSW

• Internal Medicine Physician in Peru, NY
• Providers in Peru, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.