Organization Active NPI

Prime Care Physicians, P.L.L.C.

  • Family Medicine Physician
  • Albany, NY
National Provider Identifier
1548480551
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
54964 Issued in NY
Legal business name
PRIME CARE PHYSICIANS, P.L.L.C.
Doing business as
Prime Care Physicians, P.L.L.C.
Practice address
1444 Western Ave
Suite B-2
Albany, NY 12203-3440
Phone
(518) 458-8014
Fax
(518) 533-6714
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Authorized official

Name
Mr. Michael Whalen
Title
Director of Administration
Phone
(518) 435-2704

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 54964 NY Primary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X 54964 NY
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 54964 NY
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X 54964 NY

Addresses

Primary practice location

1444 Western Ave
Suite B-2
Albany, NY 12203-3440

Mailing address

4 Atrium Dr
Suite 100
Albany, NY 12205-1441
Phone (518) 435-2704

Other identifiers 1

IdentifierTypeStateIssuer
02616571MedicaidNY

Other names 1

  • Prime Care Physicians, P.L.L.C. Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1548480551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ATRIUM DR",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051441",
            "telephone_number": "518-435-2704",
            "fax_number": "518-458-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 WESTERN AVE",
            "address_2": "SUITE B-2",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033440",
            "telephone_number": "518-458-8014",
            "fax_number": "518-533-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE PHYSICIANS, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "WHALEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "518-435-2704",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "54964",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "54964",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "54964",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "54964",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02616571",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Care Physicians, P.L.L.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.