Organization Active NPI

Capital District Gastroenterology & Liver Disease, PC

  • General Practice Physician
  • Albany, NY
National Provider Identifier
1710197058
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
088175-1 Issued in NY
Legal business name
CAPITAL DISTRICT GASTROENTEROLOGY & LIVER DISEASE, PC
Practice address
1 S Pine Ave
Albany, NY 12208-2212
Phone
(518) 489-7491
Fax
(518) 489-3439
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Authorized official

Name
Dr. James H. Puleo, MD
Title
President
Phone
(518) 489-7491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 088175-1 NY Primary

Addresses

Primary practice location

1 S Pine Ave
Albany, NY 12208-2212

Mailing address

1 S Pine Ave
Albany, NY 12208-2212
Phone (518) 489-7491

Other identifiers 1

IdentifierTypeStateIssuer
00510292MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1710197058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S PINE AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082212",
            "telephone_number": "518-489-7491",
            "fax_number": "518-489-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S PINE AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082212",
            "telephone_number": "518-489-7491",
            "fax_number": "518-489-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL DISTRICT GASTROENTEROLOGY & LIVER DISEASE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "PULEO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-489-7491",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "088175-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00510292",
            "state": "NY"
        }
    ],
    "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 Feb 5, 2009; 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.