NPIMap

Individual provider Active NPI

Marianne A Mustafa, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Malta, NY
National Provider Identifier
1497841860
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
226100 Issued in NY
Practice address
100 Saratoga Village Blvd
Suite 34
Malta, NY 12020-3737
Phone
(518) 899-9099
Fax
(518) 899-9098
NPI assigned
Oct 5, 2006
Last updated
Apr 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 226100 NY Primary

Addresses

Primary practice location

100 Saratoga Village Blvd
Suite 34
Malta, NY 12020-3737

Mailing address

100 Saratoga Village Blvd
Suite 34
Malta, NY 12020-3737
Phone (518) 899-9099

Other identifiers 1

IdentifierTypeStateIssuer
002370267MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111121000637 NY Practitioner - Family Practice 8325097793 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians
CLR Schenectady LLCGroup PAC ID 2567737893, 3 clinicians
Saratoga Family Medicine,PLLCGroup PAC ID 1153370515, 3 clinicians

Practice addresses (Care Compare)

131 Lawrence St
Saratoga Springs, NY 12866-1346
Phone (518) 587-3600

526 Altamont Ave
Schenectady, NY 12303-1039
Phone (518) 346-6121

6 Medical Park Dr
Suite 208
Malta, NY 12020-5053
Phone (518) 899-9090

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
68.51 of 100Reported as group
Quality
56.19
Improvement activities
40
Cost
75.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital CurrentSince Dec 4, 2016 Accepting new patients
Hospitalist Healthcare Services PLLC Geriatric Medicine Current Accepting new patients
Saratoga Hospital Current Accepting new patients
Saratoga Family Medicine,PLLC CurrentSince Jan 6, 2003 Accepting new patients
Saratoga Hospital Current Accepting new patients
CLR Schenectady LLC CurrentSince Dec 2, 2019 Accepting new patients
Saratoga Hospital CurrentSince Dec 4, 2016 Accepting new patients
Hospitalist Healthcare Services PLLC Geriatric Medicine CurrentSince Dec 13, 2016 Accepting new patients
Eugene K. Merecki, MD PC CurrentSince Jan 8, 2009 Accepting new patients
Seton Health at Schuyler Ridge Residential Healthcare Past Accepting new patients
Daughters of Sarah Nursing Center, Inc. Past Accepting new patients
Utah Valley Emergency Physicians Inc PastSince Dec 15, 2019 Accepting new patients
R.G. Psychological Services, P.C. Past Accepting new patients
Schenectady County Past Accepting new patients

Locations

3530 Wayne Ave
Bronx, NY 10467
Phone (718) 655-1700

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

820 Albany Shaker Rd
Loudonville, NY 12211
Phone (518) 869-2231

100 Saratoga Village Blvd
Ste 34
Malta, NY 12020
Phone (518) 899-2632

6 Medical Park Dr
Ste 208
Malta, NY 12020
Phone (518) 899-2632

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

17850 Linden Blvd
Rochdale Village, NY 11434
Phone (718) 990-0300

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

131 Lawrence St
Saratoga Springs, NY 12866
Phone (518) 587-3600

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

526 Altamont Ave
Schenectady, NY 12303
Phone (518) 346-6121

2902 Upper Tibbits Ave
Troy, NY 12180
Phone (518) 273-2040

100 Lake Rd
Vly Cottage, NY 10989
Phone (845) 268-6813

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Saratoga HospitalSaratoga Springs, NY, CCN 330222 Hospital Corporate Officer Jan 1, 2017

Owned or controlled facilities with NPI records 18

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 18

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 32

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1497841860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SARATOGA VILLAGE BLVD",
            "address_2": "SUITE 34",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120203737",
            "telephone_number": "518-899-9099",
            "fax_number": "518-899-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SARATOGA VILLAGE BLVD",
            "address_2": "SUITE 34",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120203737",
            "telephone_number": "518-899-9099",
            "fax_number": "518-899-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "MARIANNE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "226100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002370267",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malta, NY

Sources for this page

Verify at the official NPI Registry.