NPIMap

Organization Active NPI

Ellis Hospital

Doing business as Ellis Primary Care & Family Medicine Residency Program

  • Primary Care Clinic/Center
  • Schenectady, NY
National Provider Identifier
1902386485
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
4601001H Issued in NY
Legal business name
ELLIS HOSPITAL
Doing business as
Ellis Primary Care & Family Medicine Residency Program
Practice address
624 McClellan St Ste 101
Schenectady, NY 12304-1020
Phone
(518) 382-2260
NPI assigned
Aug 15, 2018
Last updated
Aug 15, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLIS HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Authorized official

Name
Paul A Milton
Title
Ceo
Phone
(518) 243-4175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 4601001H NY Primary

Addresses

Primary practice location

624 McClellan St Ste 101
Schenectady, NY 12304-1020

Mailing address

624 McClellan St Ste 101
Schenectady, NY 12304-1020
Phone (518) 382-2260

Other names 1

  • Ellis Primary Care & Family Medicine Residency Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Estrella M Martinez37 organizations share this tax ID, including this one
Part of
Estrella M Martinez

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

624 McClellan St
Ste 101
Schenectady, NY 12304
Phone (518) 347-5043

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1902386485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 MCCLELLAN ST STE 101",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041020",
            "telephone_number": "518-382-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MCCLELLAN ST STE 101",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041020",
            "telephone_number": "518-382-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIS HOSPITAL",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "MILTON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "518-243-4175"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "4601001H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellis Primary Care & Family Medicine Residency Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.