Organization Active NPI

Community Care Physicians, PC

Doing business as Community Care Delmar Medical Office

  • Internal Medicine Physician
  • Latham, NY
National Provider Identifier
1891077087
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
136154 Issued in NY
Legal business name
COMMUNITY CARE PHYSICIANS, PC
Doing business as
Community Care Delmar Medical Office
Practice address
711 Troy Schenectady Rd
Suite 203
Latham, NY 12110-2442
Phone
(518) 782-3700
Fax
(518) 782-3799
NPI assigned
Sep 13, 2011
Last updated
Sep 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Diane M Stamas
Title
Senior Credentialing Coordinator
Phone
(518) 782-3742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 136154 NY Primary

Addresses

Primary practice location

711 Troy Schenectady Rd
Suite 203
Latham, NY 12110-2442

Mailing address

250 Delaware Ave
Delmar, NY 12054-1420
Phone (518) 439-8077

Other names 1

  • Community Care Delmar Medical Office Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kevin Lau MD121 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1891077087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 DELAWARE AVE",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541420",
            "telephone_number": "518-439-8077",
            "fax_number": "518-439-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "STAMAS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "518-782-3742"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "136154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Delmar Medical Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.