NPIMap

Organization Active NPI

New York Epilepsy Medicine, PC

  • Medical Specialty Clinic/Center
  • Latham, NY
National Provider Identifier
1417344987
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
260870 Issued in NY
Legal business name
NEW YORK EPILEPSY MEDICINE, PC
Practice address
3 Lear Jet LN Ste 203
Latham, NY 12110
Phone
(518) 258-4033
Fax
(866) 581-2012
NPI assigned
Apr 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Authorized official

Name
Dr. Jess David Collins, MD
Title
President
Phone
(518) 258-4033

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 260870 NY Primary
Medical Specialty Clinic/Center 261QM2500X MD463651 PA
Medical Specialty Clinic/Center 261QM2500X 25MA10413300 NJ

Addresses

Primary practice location

3 Lear Jet LN Ste 203
Latham, NY 12110

Mailing address

3 Lear Jet LN Ste 203
Latham, NY 12110-2322
Phone (518) 258-4033

Other practice location 1

1500 Market St Fl 12
Philadelphia, PA 19102-2152
Phone (215) 665-5612

Other practice location 2

221 River St Ste 9
Hoboken, NJ 07030-5990
Phone (201) 721-8740

National Provider Directory

National Provider Directory

Locations

700 S Pearl St
Albany, NY 12202
Phone (518) 427-2233

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1417344987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LEAR JET LN STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102322",
            "telephone_number": "518-258-4033",
            "fax_number": "866-581-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LEAR JET LN STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-258-4033",
            "fax_number": "866-581-2012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Market St Fl 12",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191022152",
            "country_code": "US",
            "telephone_number": "215-665-5612",
            "fax_number": "866-581-2012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 River St Ste 9",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070305990",
            "country_code": "US",
            "telephone_number": "201-721-8740",
            "fax_number": "866-581-2012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW YORK EPILEPSY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-258-4033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "260870",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "PA",
            "license": "MD463651",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NJ",
            "license": "25MA10413300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.