Individual provider Active NPI

Erik Anthony Mastrianni

  • Case Manager/Care Coordinator
  • Lake George, NY
National Provider Identifier
1417219205
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1340 State Route 9
Municipal Center
Lake George, NY 12845-3434
Phone
(518) 859-2877
Fax
(518) 761-6354
NPI assigned
Jun 8, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

1340 State Route 9
Municipal Center
Lake George, NY 12845-3434

Mailing address

1340 State Route 9
Municipal Center
Lake George, NY 12845-3434
Phone (518) 859-2877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1417219205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 STATE ROUTE 9",
            "address_2": "MUNICIPAL CENTER",
            "city": "LAKE GEORGE",
            "state": "NY",
            "postal_code": "128453434",
            "telephone_number": "518-859-2877",
            "fax_number": "518-761-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 STATE ROUTE 9",
            "address_2": "MUNICIPAL CENTER",
            "city": "LAKE GEORGE",
            "state": "NY",
            "postal_code": "128453434",
            "telephone_number": "518-859-2877",
            "fax_number": "518-761-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRIANNI",
        "first_name": "ERIK",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake George, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.