NPIMap

Organization Active NPI

Nysarc, Inc. Montgomery County Chapter

  • Voluntary or Charitable Agency
  • Amsterdam, NY
National Provider Identifier
1386849933
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
License
141113 Issued in NY
Legal business name
NYSARC, INC. MONTGOMERY COUNTY CHAPTER
Practice address
43 Liberty Dr
Amsterdam, NY 12010-5635
Phone
(518) 842-5080
Fax
(518) 842-0143
NPI assigned
Jun 15, 2007
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
Ms. Jennifer M Saunders
Title
Reimbursement Manager
Phone
(518) 954-3223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X 141113 NY Primary

Addresses

Primary practice location

43 Liberty Dr
Amsterdam, NY 12010-5635

Mailing address

43 Liberty Dr
Amsterdam, NY 12010-5635
Phone (518) 842-5080

Other identifiers 4

IdentifierTypeStateIssuer
02599411MedicaidNY
01750518MedicaidNY
01385217MedicaidNY
02617792MedicaidNY

Other names 1

  • Liberty ARC Other name

National Provider Directory

National Provider Directory
Tax ID family
Liberty5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386849933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 LIBERTY DR",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120105635",
            "telephone_number": "518-842-5080",
            "fax_number": "518-842-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 LIBERTY DR",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120105635",
            "telephone_number": "518-842-5080",
            "fax_number": "518-842-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYSARC, INC. MONTGOMERY COUNTY CHAPTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "REIMBURSEMENT MANAGER",
        "authorized_official_telephone_number": "518-954-3223",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NY",
            "license": "141113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02599411",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01750518",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01385217",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02617792",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty ARC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Amsterdam, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.