NPIMap

Organization Active NPI

Elmira PC

  • Health Maintenance Organization
  • Elmira, NY
National Provider Identifier
1770775504
Registry record updated Sep 3, 2014
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Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
ELMIRA PC
Practice address
100 Washington St
Elmira, NY 14901-2849
Phone
(607) 737-4739
NPI assigned
Aug 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Authorized official

Name
Robert Puccio
Title
Director Finance
Phone
(518) 473-0795

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

100 Washington St
Elmira, NY 14901-2849

Mailing address

44 Holland Avenue
Albany, NY 12229-0001

Other identifiers 1

IdentifierTypeStateIssuer
02890875MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Middletown Psychiatric Center146 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409702400000",
    "number": "1770775504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 HOLLAND AVENUE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122290001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASHINGTON ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149012849",
            "telephone_number": "607-737-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMIRA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2014-09-03",
        "status": "A",
        "authorized_official_last_name": "PUCCIO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR FINANCE",
        "authorized_official_telephone_number": "518-473-0795"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02890875",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.