Columbia Memorial Regional Medical PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

COLUMBIA MEMORIAL REGIONAL MEDICAL PLLC

Practice address

24 Lafayette Ave
Coxsackie, NY 12051-1305

Phone

(518) 731-7770

NPI assigned

Feb 17, 2021

Organization subpart

No

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

Authorized official

Name

Bryan T. Mahoney

Title

Chief Financial Officer

Phone

(518) 828-8090

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CMH-Lafayette Family Care Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

CMH Rapid Care- Catskill4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Columbia Memorial Regional Medical PLLC

  • Multi-Specialty Clinic/Center
  • Cairo, NY
  • NPI 1518550037
  NPD tax ID
• Columbia Memorial Regional Medical PLLC

  • Multi-Specialty Clinic/Center
  • Tannersville, NY
  • NPI 1679166284
  NPD tax ID
• Columbia Memorial Regional Medical PLLC

  • Multi-Specialty Clinic/Center
  • Catskill, NY
  • NPI 1689267288
  NPD tax ID

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1417540824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342000",
            "telephone_number": "518-828-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 LAFAYETTE AVE",
            "city": "COXSACKIE",
            "state": "NY",
            "postal_code": "120511305",
            "telephone_number": "518-731-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA MEMORIAL REGIONAL MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "518-828-8090"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03227290",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMH-Lafayette Family Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CMH-Lafayette Family Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Barbara Abigide
• Bianca Lincon Barbour, LMSW
• Abigail Breen, R.N.
• Sara Collesides, NP
• Coxsackie Family Practice
• Coxsackie Optometric PC
• Coxsackie Rescue Squad
• Coxsackie Transport, Inc.
• Coxsackie-Athens CSD

• Multi-Specialty Clinic/Center in Coxsackie, NY
• Providers in Coxsackie, NY by specialty
• Multi-Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.