Doreen Smith, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

199452 Issued in NY

Practice address

165 Plank Rd
Coxsackie, NY 12051-2617

Phone

(518) 731-2741

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1881714319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PINE KNOB DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035218",
            "telephone_number": "518-937-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 PLANK RD",
            "city": "COXSACKIE",
            "state": "NY",
            "postal_code": "120512617",
            "telephone_number": "518-731-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DOREEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "199452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10010842",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "78O623",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maura Pearlstein
• Mark S Petersen, DDS
• Mary Ann Proper, RN CWOCN
• D Ann Rugh, PT
• Thomas Anthony Russo, PA
• State of New York Office of State Comptroller (Coxsackie Pharmacy)
• Town of Coxsackie
• Patricia Anne Ublackerp, TSHH/SP ED
• Annalisa Viscusi, COTA

• Internal Medicine Physician in Coxsackie, NY
• Providers in Coxsackie, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.