Organization Active NPI

Medical Associates of the Hudson Valley

  • Family Medicine Physician
  • Woodstock, NY
National Provider Identifier
1336906304
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL ASSOCIATES OF THE HUDSON VALLEY
Practice address
9 Elwyn LN
Woodstock, NY 12498-1301
Phone
(845) 338-7140
Fax
(845) 338-7141
NPI assigned
Mar 5, 2024
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDICAL ASSOCIATES OF THE HUDSON VALLEYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Marc Tack, DONPI 1376582015
Title
Managing Partner
Phone
(845) 338-7140

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

9 Elwyn LN
Woodstock, NY 12498-1301

Mailing address

360 Washington Ave
Kingston, NY 12401-3702
Phone (845) 338-7140

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0163137Medical Associates of the Hudson Valley PC9 Elwyn Lane, Woodstock, NY 12498Certificate of waiverSep 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Medical Assoc of the Hu6 organizations share this tax ID, including this one
Part of
Medical Assoc of the Hu

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1709596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1336906304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WASHINGTON AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013702",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 ELWYN LN",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124981301",
            "telephone_number": "845-338-7140",
            "fax_number": "845-338-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF THE HUDSON VALLEY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL ASSOCIATES OF THE HUDSON VALLEY",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "TACK",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "845-338-7140",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.