Individual provider Active NPI

Ranen Chakraborty

  • Family Medicine Physician
  • Latham, NY
National Provider Identifier
1689764227
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
207172 Issued in NY
Practice address
6 Wellness Way Ste 109
Latham, NY 12110-2156
Phone
(518) 785-5881
Fax
(518) 783-8510
NPI assigned
Oct 13, 2006
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 207172 NY Primary

Addresses

Primary practice location

6 Wellness Way Ste 109
Latham, NY 12110-2156

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Other identifiers 1

IdentifierTypeStateIssuer
02252133MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050602000613 NY Practitioner - Family Practice 3173566056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

1783 Route 9
Suite 202
Halfmoon, NY 12065-2466
Phone (518) 383-2366

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207172NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PC CurrentSince Jan 1, 2023 Accepting new patients
Community Care Physicians, PLLC Family Medicine CurrentSince Apr 23, 2005 Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

1783 Route 9
Ste 202
Halfmoon, NY 12065
Phone (518) 383-2366

6 Wellness Way
Ste 109
Latham, NY 12110
Phone (518) 785-5881

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 104
Latham, NY 12110
Phone (518) 782-3813

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

Organizations & group practices 3

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 4

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1689764227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 109",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-785-5881",
            "fax_number": "518-783-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKRABORTY",
        "first_name": "RANEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "207172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02252133",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.