Active NPI
Philip John Mika, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- Schenectady, NY
National Provider Identifier
1811910425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 115728
- Practice address
- 2125 River Rd
Suite 303
Schenectady, NY 12309-1135 - Phone
- (518) 382-8350
- Fax
- (518) 382-0345
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 115728 | NY | Primary |
Addresses
Primary practice location
2125 River Rd
Suite 303
Schenectady, NY 12309-1135
Mailing address
2125 River Rd
Suite 303
Schenectady, NY 12309-1135
Phone (518) 382-8350
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070119000062 | Other | NY | FIDELIS - ENDOCRINOLOGY |
| 4625730 | Other | NY | AETNA |
| 47346 | Other | NY | GHI/HMO |
| 28N081 | Other | NY | EMPIRE BC |
| 200097 | Other | NY | SENIOR WHOLE HEALTH |
| 000408519001 | Other | NY | BSNENY |
| 11120 | Other | NY | MVP |
| 28102 | Other | NY | MVP |
| 00527477 | Medicaid | NY | |
| 041208000020 | Other | NY | FIDELIS - INT MEDICINE |
| 10001371 | Other | NY | CDPHP |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115728 | NY | MD | Social Worker |
| 157281 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Physicians, PC | Endocrinology, Diabetes & Metabolism | Past | 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.
-
- Family Medicine Physician
- Albany, NY
- NPI 1811946775
Endocrinology, Diabetes & Metabolism
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358985600000",
"number": "1811910425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2125 RIVER RD",
"address_2": "SUITE 303",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123091135",
"telephone_number": "518-382-8350",
"fax_number": "518-382-0345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 RIVER RD",
"address_2": "SUITE 303",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123091135",
"telephone_number": "518-382-8350",
"fax_number": "518-382-0345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKA",
"first_name": "PHILIP",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2013-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "NY",
"license": "115728",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS - ENDOCRINOLOGY",
"identifier": "070119000062",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4625730",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI/HMO",
"identifier": "47346",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC",
"identifier": "28N081",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENIOR WHOLE HEALTH",
"identifier": "200097",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSNENY",
"identifier": "000408519001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "11120",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "28102",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00527477",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS - INT MEDICINE",
"identifier": "041208000020",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10001371",
"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 Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.