Michael Edward Phillips, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

1854331 Issued in NY

Practice address

762 Route 3
Suite 14
Plattsburgh, NY 12901-7472

Phone

(518) 562-3204

Fax

(518) 563-0707

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valcour Imaging LLC

  • Radiology Clinic/Center
  • Plattsburgh, NY
  • NPI 1962455006
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619934148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 JERRY DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011422",
            "telephone_number": "518-561-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 ROUTE 3",
            "address_2": "SUITE 14",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129017472",
            "telephone_number": "518-562-3204",
            "fax_number": "518-563-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "1854331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01264126",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dhiraj Phadtare, P.T.
• PHG Medical Office, LLP
• Brenda M. Phillips, MD
• Brigitte Louise Phillips, M.S.
• Dove Phillips, LMHC, ATR-BC
• Robert E. Phillips, A.B.O.C.
• Jacques Piche, M.D., F.R.S.C. (C)
• Jennifer Barbara Pierce, PHARM.D., R.PH.
• Nicole Pierce, RN
• Roseanna F Pierce, OT

• Diagnostic Radiology Physician in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.