Active NPI
Saratoga Family Medicine,PLLC
- Family Medicine Physician
- Malta, NY
National Provider Identifier
1386730752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 226100
- 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
- Organization subpart
- No
Practitioners 14
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Fort Edward, NY
- NPI 1790123388
-
- Family Nurse Practitioner
- Latham, NY
- NPI 1659891810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
6 Medical Park Dr
Ste 208
Malta, NY 12020
Phone (518) 899-2632
100 Saratoga Village Blvd
Ste 34
Malta, NY 12020
Phone (518) 899-2632
NPPES NPI Registry
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.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
NPI Registry JSON
{
"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.