Individual provider Active NPI

Siren Rasik Chudgar, M.D.

  • Family Medicine Physician
  • Schenectady, NY
National Provider Identifier
1770518722
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
227617 Issued in NY
Practice address
976 Balltown Rd
Schenectady, NY 12309-6428
Phone
(518) 393-0391
Fax
(518) 372-3281
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 227617 NY Primary

Addresses

Primary practice location

976 Balltown Rd
Schenectady, NY 12309-6428

Mailing address

976 Balltown Rd
Schenectady, NY 12309-6428
Phone (518) 393-0391

Other identifiers 7

IdentifierTypeStateIssuer
74562OtherNYGHI/HMO
02458639MedicaidNY
10070848OtherNYCDPHP
72V691OtherNYEMPIRE BC
363060OtherNYMVP
7814611OtherNYAETNA
000403932001OtherNYBSNENY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
227617NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PC Family Medicine PastSince Jan 1, 1998 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770518722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 BALLTOWN RD",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123096428",
            "telephone_number": "518-393-0391",
            "fax_number": "518-372-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 BALLTOWN RD",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123096428",
            "telephone_number": "518-393-0391",
            "fax_number": "518-372-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUDGAR",
        "first_name": "SIREN",
        "middle_name": "RASIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "227617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI/HMO",
            "identifier": "74562",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02458639",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10070848",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC",
            "identifier": "72V691",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "363060",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7814611",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSNENY",
            "identifier": "000403932001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.