Organization Active NPI

Capital Region OB-GYN

  • Obstetrics & Gynecology Physician
  • Latham, NY
National Provider Identifier
1902050529
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
226189-1 Issued in NY
Legal business name
CAPITAL REGION OB-GYN
Practice address
711 Troy Schenectady Rd
Suite 205
Latham, NY 12110-2442
Phone
(518) 783-7070
Fax
(518) 783-3159
NPI assigned
Nov 10, 2008
Last updated
Nov 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2008

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

Authorized official

Name
Elina Burstyn, D.O.NPI 1437177334
Title
Member
Phone
(518) 783-7070

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
Obstetrics & Gynecology Physician 207V00000X 226189-1 NY Primary

Addresses

Primary practice location

711 Troy Schenectady Rd
Suite 205
Latham, NY 12110-2442

Mailing address

711 Troy Schenectady Rd
Suite 205
Latham, NY 12110-2442
Phone (518) 783-7070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081110000601 NY Part B Supplier - Clinic/Group Practice 9335208099 Receives reassigned benefits from 4 practitioners
Practice locations: Latham, NY

National Provider Directory

National Provider Directory

Locations

711 Troy Schenectady Rd
Ste 205
Latham, NY 12110
Phone (518) 783-7070

Practitioners & affiliated clinicians

Practitioners 6

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": "1226275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1902050529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 205",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-783-7070",
            "fax_number": "518-783-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 205",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-783-7070",
            "fax_number": "518-783-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION OB-GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-10",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "BURSTYN",
        "authorized_official_first_name": "ELINA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "518-783-7070",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "226189-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.