NPIMap

Organization Active NPI

Central Leatherstocking Medical, PLLC

  • Family Medicine Physician
  • West Winfield, NY
National Provider Identifier
1578585014
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
175678 Issued in NY
Legal business name
CENTRAL LEATHERSTOCKING MEDICAL, PLLC
Practice address
943 US Highway 20
West Winfield, NY 13491-1920
Phone
(315) 822-3200
Fax
(315) 822-5193
NPI assigned
Jul 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joseph C Booth, MD
Title
Physician
Phone
(315) 822-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 175678 NY Primary

Addresses

Primary practice location

943 US Highway 20
West Winfield, NY 13491-1920

Mailing address

943 US Highway 20
West Winfield, NY 13491
Phone (315) 822-3200

Other identifiers 1

IdentifierTypeStateIssuer
02702638MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578585014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 US HIGHWAY 20",
            "city": "WEST WINFIELD",
            "state": "NY",
            "postal_code": "13491",
            "telephone_number": "315-822-3200",
            "fax_number": "315-822-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 US HIGHWAY 20",
            "city": "WEST WINFIELD",
            "state": "NY",
            "postal_code": "134911920",
            "telephone_number": "315-822-3200",
            "fax_number": "315-822-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL LEATHERSTOCKING MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "315-822-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "175678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02702638",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Winfield, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.