NPIMap

Individual provider Active NPI

Craig W Richards, D.O.

  • Internal Medicine Physician
  • Malone, NY
National Provider Identifier
1568447993
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
213152-1 Issued in NY
Practice address
380 County Rte 51
Malone, NY 12953-4504
Phone
(518) 483-0109
Fax
(518) 483-0115
NPI assigned
Dec 8, 2005
Last updated
Mar 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 213152 NY
Internal Medicine Physician 207R00000X 213152-1 NY Primary

Addresses

Primary practice location

380 County Rte 51
Malone, NY 12953-4504

Mailing address

380 County Rte 51
Malone, NY 12953-4504
Phone (518) 483-0109

Other identifiers 4

IdentifierTypeStateIssuer
01995615MedicaidNY
RA8810OtherNYFRANKLIN COUNTY NURSING H
BB7507OtherNYALICE HYDE MEDICAL CENTER
01955586MedicaidNY

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
I20040630000736 NY Practitioner - Internal Medicine 7911984760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

380 County Route 51
Malone, NY 12953-4504
Phone (518) 483-0109

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213152NYMDInternal Medicine Physician
213152-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Association of the North Country, Inc. CurrentSince Jan 2, 2013 Accepting new patients
Malone Internal Medicine PC Internal Medicine PastSince Aug 2, 1999 Accepting new patients
Alice Hyde Medical Center Past Accepting new patients
St Josephs Rehabilitation Center, Inc Past Accepting new patients

Locations

4 Commerce Ln
Canton, NY 13617
Phone (315) 386-1156

380 County Route 51
Malone, NY 12953
Phone (518) 483-0109

Ownership & related parties

All facility ownership & control disclosures 9

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

FacilityTypeRoleSince
The University of Vermont Health Network-Alice Hyde Medical CenterMalone, NY, CCN 331321 Hospital Corporate Director Mar 24, 2022
The University of Vermont Health Network-Alice Hyde Medical CenterMalone, NY, CCN 33Z321 Hospital Corporate Director Mar 24, 2022
Alice Hyde Nursing HomeMalone, NY, CCN 335127 Skilled nursing facility Corporate Director
Trustee of the SNF		 Mar 24, 2022
Mar 24, 2022
Alice Hyde Medical CenterMoira, NY, CCN 333981 Rural health clinic Corporate Officer Jun 1, 2022
Alice Hyde Medical CenterChateaugay, NY, CCN 333980 Rural health clinic Corporate Officer Jun 1, 2022
Alice Hyde Medical CenterFort Covington, NY, CCN 333982 Rural health clinic Corporate Officer Jun 1, 2022
Alice Hyde Medical CenterSaint Regis Falls, NY, CCN 333983 Rural health clinic Corporate Officer Jun 1, 2022
University of Vermont Alice Hyde Medical Center Medical PracticesMalone, NY, CCN 333998 Rural health clinic Corporate Officer Jun 1, 2022
Malone Medical PracticesMalone, NY, CCN 338503 Rural health clinic Corporate Director Aug 1, 2022

Owned or controlled facilities with NPI records 4

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

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1568447993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 COUNTY RTE 51",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129534504",
            "telephone_number": "518-483-0109",
            "fax_number": "518-483-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 COUNTY RTE 51",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129534504",
            "telephone_number": "518-483-0109",
            "fax_number": "518-483-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "CRAIG",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "213152",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "213152-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01995615",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FRANKLIN COUNTY NURSING H",
            "identifier": "RA8810",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALICE HYDE MEDICAL CENTER",
            "identifier": "BB7507",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01955586",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malone, NY

Sources for this page

Verify at the official NPI Registry.