Organization Active NPI

Mohawk Valley Medical Anesthesiology Associates, PLLC

  • Anesthesiology Physician
  • Amsterdam, NY
National Provider Identifier
1811090467
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
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

Updated by the provider on Dec 13, 2010

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)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
02067090MedicaidNY

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.