Active NPI
Holly Wasniewski, D.O.
- Family Medicine Physician
- Charlton, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 240602
- Practice address
- 286 Stage Rd
Charlton, NY 12019-2618 - Phone
- (518) 399-2101
- Fax
- (518) 399-2130
- NPI assigned
- Nov 15, 2006
- Last updated
- Mar 27, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 240602 | NY | Primary |
Addresses
Primary practice location
286 Stage Rd
Charlton, NY 12019-2618
Mailing address
711 Troy Schenectady Rd Ste 203
Latham, NY 12110-2461
Phone (518) 782-3700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02826373 | 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
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
61 Rowland St
Ballston Spa, NY 12020-1135
Phone (518) 885-6721
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240602 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Physicians, PLLC | Family Medicine | Current | Accepting new patients |
| Community Care Physicians, PLLC | Family Medicine | Past | Accepting new patients |
Locations
501 New Karner Rd
Ste 1A
Albany, NY 12205
Phone (518) 452-1337
20 Prospect St
Ste 106
Ballston Spa, NY 12020
Phone (518) 855-3755
61 Rowland St
Ballston Spa, NY 12020
Phone (518) 232-1759
286 Stage Rd
Charlton, NY 12019
Phone (518) 399-2101
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
711 Troy Schenectady Rd
Ste 210
Latham, NY 12110
3732 Carman Rd
Schenectady, NY 12303
Phone (518) 356-4132
Interoperability endpoints
- hollywasniewski@ccp.allscriptsdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Latham, NY
- NPI 1922048370
Family Medicine
-
dba Community Care Family Practice Ballston Spa
- Family Medicine Physician
- Ballston Spa, NY
- NPI 1548541246
Hospital & facility affiliations 18
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Gansevoort, NY
- NPI 1033371166
Hospital
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1073569331
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1093078560
-
dba Schuylerville Family Health
- Primary Care Clinic/Center
- Schuylerville, NY
- NPI 1568707289
Hospital
-
dba Galway Family Health
- Primary Care Clinic/Center
- Galway, NY
- NPI 1649515214
Hospital
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1700120482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522108800000",
"number": "1417020090",
"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": "286 STAGE RD",
"city": "CHARLTON",
"state": "NY",
"postal_code": "120192618",
"telephone_number": "518-399-2101",
"fax_number": "518-399-2130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASNIEWSKI",
"first_name": "HOLLY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2018-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "240602",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02826373",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.