NPIMap

Organization Active NPI

Saratoga County

  • Community/Behavioral Health Agency
  • Saratoga Springs, NY
National Provider Identifier
1700912367
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
651100A Issued in NY
Legal business name
SARATOGA COUNTY
Practice address
135 S Broadway
Saratoga Springs, NY 12866-4532
Phone
(518) 584-9030
Fax
(518) 581-1709
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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

Authorized official

Name
Michael S Prezioso, PH.D
Title
Director
Phone
(518) 584-9030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 651100A NY Primary

Addresses

Primary practice location

135 S Broadway
Saratoga Springs, NY 12866-4532

Mailing address

135 S Broadway
Saratoga Springs, NY 12866-4532
Phone (518) 584-9030

Other identifiers 1

IdentifierTypeStateIssuer
00639496MedicaidNY

Other names 1

  • Saratoga County Mental Health Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422001361 NY Part B Supplier - Clinic/Group Practice 7810983012 Receives reassigned benefits from 21 practitioners
Practice locations: Saratoga Springs, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2176052Saratoga County Mental Health and Addiction135 S Broadway, Saratoga Springs, NY 12866Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Saratoga County Laboratory6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

135 S Broadway
Saratoga Springs, NY 12866
Phone (518) 584-9030

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425600000000",
    "number": "1700912367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S BROADWAY",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128664532",
            "telephone_number": "518-584-9030",
            "fax_number": "518-581-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S BROADWAY",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128664532",
            "telephone_number": "518-584-9030",
            "fax_number": "518-581-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARATOGA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-03-06",
        "status": "A",
        "authorized_official_last_name": "PREZIOSO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "518-584-9030",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "651100A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00639496",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saratoga County Mental Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.