Organization Active NPI

Img Ny LLC

  • Internal Medicine Physician
  • Albany, NY
National Provider Identifier
1609390715
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IMG NY LLC
Practice address
80 State St
Albany, NY 12207-2541
Phone
(800) 564-1303
NPI assigned
Jul 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Tim McMenamin
Title
Manager
Phone
(800) 564-1303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

80 State St
Albany, NY 12207-2541

Mailing address

80 State St
Albany, NY 12207-2541
Phone (800) 564-1303

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609390715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 STATE ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072541",
            "telephone_number": "800-564-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 STATE ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072541",
            "telephone_number": "800-564-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMG NY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MCMENAMIN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "800-564-1303"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2022; 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.