NPIMap

Organization Active NPI

Community Care Physicians, PC

  • Family Medicine Physician
  • Halfmoon, NY
National Provider Identifier
1770867103
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
184866 Issued in NY
Legal business name
COMMUNITY CARE PHYSICIANS, PC
Practice address
1783 Route 9
Suite 204
Halfmoon, NY 12065-2409
Phone
(518) 371-9355
Fax
(518) 373-9139
NPI assigned
Oct 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Authorized official

Name
Diane M Stamas
Title
Senior Credentialing Coordinator
Phone
(518) 782-3742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 184866 NY Primary

Addresses

Primary practice location

1783 Route 9
Suite 204
Halfmoon, NY 12065-2409

Mailing address

711 Troy Schenectady Rd
Suite 203
Latham, NY 12110-2442
Phone (518) 782-3700

Other names 1

  • Community Care Family Medicine Doing business as

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
33D0944201Community Care Family Medicine Group1783 Route 9, Suite 204, Clifton Park, NY 12065Provider-performed microscopyApr 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
East Hudson Community C121 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

Locations

1783 Route 9
Ste 204
Halfmoon, NY 12065
Phone (518) 371-9355

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1770867103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "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": "1783 ROUTE 9",
            "address_2": "SUITE 204",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120652409",
            "telephone_number": "518-371-9355",
            "fax_number": "518-373-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "STAMAS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "518-782-3742"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "184866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Halfmoon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.