Organization Active NPI

John M. Pramenko, MD, P.C.

  • Family Medicine Physician
  • Niskayuna, NY
National Provider Identifier
1821293309
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
203711 Issued in NY
Legal business name
JOHN M. PRAMENKO, MD, P.C.
Practice address
2310 Nott St E
Niskayuna, NY 12309-4303
Phone
(518) 381-4133
NPI assigned
Jun 15, 2007
Last updated
Dec 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

Name
Dr. John M Pramenko, MDNPI 1477529048
Title
President
Phone
(518) 381-4133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 203711 NY Primary

Addresses

Primary practice location

2310 Nott St E
Niskayuna, NY 12309-4303

Mailing address

2310 Nott St E
Niskayuna, NY 12309-4303
Phone (518) 381-4133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070927000658 NY Part B Supplier - Clinic/Group Practice 8921193566 Receives reassigned benefits from 2 practitioners
Practice locations: Niskayuna, NY

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
33D1073622John M Pramenko MD PC2310 Nott Street East, Niskayuna, NY 12309Certificate of waiverSep 12, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1821293309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 NOTT ST E",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "123094303",
            "telephone_number": "518-381-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 NOTT ST E",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "123094303",
            "telephone_number": "518-381-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M. PRAMENKO, MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "PRAMENKO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-381-4133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "203711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niskayuna, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.