NPIMap

Organization Active NPI

Saratoga Family Medicine,PLLC

  • Family Medicine Physician
  • Malta, NY
National Provider Identifier
1386730752
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
226100 Issued in NY
Legal business name
SARATOGA FAMILY MEDICINE,PLLC
Practice address
100 Saratoga Village Blvd
Suite 34
Malta, NY 12020-3737
Phone
(518) 899-9090
Fax
(518) 899-9098
NPI assigned
Oct 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marianne A Mustafa, M.D.NPI 1497841860
Title
Owner
Phone
(518) 899-9090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 226100 NY Primary

Addresses

Primary practice location

100 Saratoga Village Blvd
Suite 34
Malta, NY 12020-3737

Mailing address

100 Saratoga Village Blvd
Suite 34
Malta, NY 12020-3737
Phone (518) 899-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050113000086 NY Part B Supplier - Clinic/Group Practice 1153370515 Receives reassigned benefits from 9 practitioners
Practice locations: Albany, NY; Clifton Park, NY; Malta, NY; Schenectady, NY

National Provider Directory

National Provider Directory

Locations

1 Abele Dr
Clifton Park, NY 12065
Phone (518) 213-2032

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386730752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SARATOGA VILLAGE BLVD",
            "address_2": "SUITE 34",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120203737",
            "telephone_number": "518-899-9090",
            "fax_number": "518-899-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SARATOGA VILLAGE BLVD",
            "address_2": "SUITE 34",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120203737",
            "telephone_number": "518-899-9090",
            "fax_number": "518-899-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARATOGA FAMILY MEDICINE,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUSTAFA",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-899-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "226100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.