Active NPI
Mohawk Valley Medical Anesthesiology Associates, PLLC
- Anesthesiology Physician
- Amsterdam, NY
National Provider Identifier
1811090467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- MOHAWK VALLEY MEDICAL ANESTHESIOLOGY ASSOCIATES, PLLC
- Practice address
- 178 Clizbe Ave
Amsterdam, NY 12010-7520 - Phone
- (518) 843-8745
- Fax
- (518) 842-9633
- NPI assigned
- Sep 7, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Marybeth Beck
- Title
- Office Manager
- Phone
- (518) 843-8745
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
178 Clizbe Ave
Amsterdam, NY 12010-7520
Mailing address
178 Clizbe Ave
Amsterdam, NY 12010-7520
Phone (518) 843-8745
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02067090 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1292198400000",
"number": "1811090467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "178 CLIZBE AVE",
"city": "AMSTERDAM",
"state": "NY",
"postal_code": "120107520",
"telephone_number": "518-843-8745",
"fax_number": "518-842-9633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "178 CLIZBE AVE",
"city": "AMSTERDAM",
"state": "NY",
"postal_code": "120107520",
"telephone_number": "518-843-8745",
"fax_number": "518-842-9633"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOHAWK VALLEY MEDICAL ANESTHESIOLOGY ASSOCIATES, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2010-12-13",
"status": "A",
"authorized_official_last_name": "BECK",
"authorized_official_first_name": "MARYBETH",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "518-843-8745",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02067090",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Amsterdam, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.