Individual provider Active NPI

Brigid Mack, M.D.

  • Family Medicine Physician
  • Albany, NY
National Provider Identifier
1861612814
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
249141 Issued in NY
Practice address
391 Myrtle Ave Ste 4a
Albany, NY 12208-3797
Phone
(518) 207-2273
Fax
(518) 207-2293
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 249141 NY Primary

Addresses

Primary practice location

391 Myrtle Ave Ste 4a
Albany, NY 12208-3797

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
03015689MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080826000362 NY Practitioner - Family Practice 3274608203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

6 Wellness Way
Latham, NY 12110-2156
Phone (518) 782-3700

711 Troy Schenectady Rd
Latham, NY 12110-2461

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC Family Medicine CurrentSince Sep 1, 2009 Accepting new patients
Upper Hudson Planned Parenthood Inc. CurrentSince Jan 16, 2014 Accepting new patients
Planned Parenthood of Central and Western New York, Inc Past Accepting new patients
Albany Medical Center Hospital Past Accepting new patients

Locations

391 Myrtle Ave
Ste 4A
Albany, NY 12208
Phone (518) 202-2273

2 Clara Barton Dr
Ste 201
Albany, NY 12208
Phone (518) 207-2273

855 Central Ave
Albany, NY 12206
Phone (518) 434-5678

855 Central Ave
Ste 3
Albany, NY 12206
Phone (518) 434-5678

804 Columbia St
Hudson, NY 12534
Phone 5184345678 ext. 210

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 201
Latham, NY 12110

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

120 Hoosick St
Ste 12
Troy, NY 12180
Phone (518) 434-5678

Interoperability endpoints

  • Direct secure messaging: brigid.mack.p6@direct.usppny.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1861612814",
    "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": "391 MYRTLE AVE STE 4A",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083797",
            "telephone_number": "518-207-2273",
            "fax_number": "518-207-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "BRIGID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "249141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03015689",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.