NPIMap

Organization Active NPI

Community Care Physicians, PC

Doing business as Community Care Pediatrics - Saratoga

  • Pediatrics Physician
  • Latham, NY
National Provider Identifier
1356623540
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
135597 Issued in NY
Legal business name
COMMUNITY CARE PHYSICIANS, PC
Doing business as
Community Care Pediatrics - Saratoga
Practice address
711 Troy Schenectady Rd
Suite 203
Latham, NY 12110-2442
Phone
(518) 782-3700
Fax
(518) 782-3799
NPI assigned
Sep 13, 2011
Last updated
May 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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
Pediatrics Physician 208000000X 135597 NY Primary

Addresses

Primary practice location

711 Troy Schenectady Rd
Suite 203
Latham, NY 12110-2442

Mailing address

6 Mountain Ledge
Gansevoort, NY 12831-2539
Phone (518) 584-0355

Other names 1

  • Community Care Pediatrics - Saratoga Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kevin Lau MD121 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

Locations

6 Mountain Ledge
Gansevoort, NY 12831
Phone (518) 584-0335

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1356623540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MOUNTAIN LEDGE",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "128312539",
            "telephone_number": "518-584-0355",
            "fax_number": "518-583-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2015-05-14",
        "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": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "135597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Pediatrics - Saratoga",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.