Family Medicine of Mechanicville PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

236934 Issued in NY

Legal business name

FAMILY MEDICINE OF MECHANICVILLE PLLC

Practice address

242 S Central Ave
Mechanicville, NY 12118-3522

Phone

(518) 664-4185

Fax

(518) 539-2003

NPI assigned

Apr 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Ingrid Bermudez, MDNPI 1295824134

Title

Owner

Phone

(518) 664-4185

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 2

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

• Ingrid Bermudez, M.D.

  • Family Medicine Physician
  • Mechanicville, NY
  • NPI 1295824134
  Medicare reassignment Care Compare group NPD Authorized official
• Nicole Marie Cregan, FNP

  • Family Nurse Practitioner
  • Waterford, NY
  • NPI 1134948573
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1487898425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 S CENTRAL AVE",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "121183522",
            "telephone_number": "518-664-4185",
            "fax_number": "518-539-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 S CENTRAL AVE",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "121183522",
            "telephone_number": "518-664-4185",
            "fax_number": "518-539-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE OF MECHANICVILLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "BERMUDEZ",
        "authorized_official_first_name": "INGRID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-664-4185",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "236934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Doran Dennett, MS,ATC
• Lynn Dorr, LCSW
• Petra V. Enzien, DMD
• Erin Summers Speech Therapy Inc
• Family Dental Associates LLP
• McKenzie Leigh Flemming, PA-C
• Mary E Ford, RN
• Sierra Frederick, LMSW
• Melissa Fronhofer, MSPT
• Vincent Pat Fuschino, DDS

• Primary Care Clinic/Center in Mechanicville, NY
• Providers in Mechanicville, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.