Active NPI
Michael P Morin, M.D.
- Pediatrics Physician
- Albany, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 177463
- Practice address
- 6 Executive Park Dr
Albany, NY 12203-3791 - Phone
- (518) 641-6319
- Fax
- (518) 641-6850
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 177463 | NY | Primary |
Addresses
Primary practice location
6 Executive Park Dr
Albany, NY 12203-3791
Mailing address
711 Troy Schenectady Rd Ste 203
Latham, NY 12110-2461
Phone (518) 782-3700
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 711043 | Other | NY | MVP |
| 72670 | Other | NY | GHI/HMO |
| 070123000054 | Other | NY | FIDELIS |
| 193AS1 | Other | NY | EMPIRE BC |
| 5002022 | Other | NY | AETNA |
| 000401053014 | Other | NY | BSNENY |
| 10006143 | Other | NY | CDPHP |
| 200094 | Other | NY | SENIOR WHOLE HEALTH |
| 01249834 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 177463 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Physicians, PLLC | Pediatrics | Current | Accepting new patients |
| Community Care Physicians, PLLC | Past | Accepting new patients |
Locations
501 New Karner Rd
Ste 1A
Albany, NY 12205
Phone (518) 452-1337
47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773
20 Prospect St
Ste 106
Ballston Spa, NY 12020
Phone (518) 855-3755
711 Troy Schenectady Rd
Ste 210
Latham, NY 12110
6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900
711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742
3732 Carman Rd
Schenectady, NY 12303
Phone (518) 356-4132
6 Executive Park Dr
Stuyvesant Plaza, NY 12203
Phone (518) 482-9111
Interoperability endpoints
- mmorin788383@direct.trinity-health.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Ballston Spa, NY
- NPI 1548541246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516233600000",
"number": "1396831764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 TROY SCHENECTADY RD STE 203",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102461",
"telephone_number": "518-782-3700",
"fax_number": "518-782-3799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 EXECUTIVE PARK DR",
"city": "ALBANY",
"state": "NY",
"postal_code": "122033791",
"telephone_number": "518-641-6319",
"fax_number": "518-641-6850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORIN",
"first_name": "MICHAEL",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2018-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "177463",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "711043",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI/HMO",
"identifier": "72670",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "070123000054",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC",
"identifier": "193AS1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5002022",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSNENY",
"identifier": "000401053014",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10006143",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENIOR WHOLE HEALTH",
"identifier": "200094",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01249834",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.