NPIMap

Organization Active NPI

Marc D Price DO PLLC

Doing business as Family Medicine of Malta

  • Family Medicine Physician
  • Mechancville, NY
National Provider Identifier
1902816473
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
219996 Issued in NY
Legal business name
MARC D PRICE DO PLLC
Doing business as
Family Medicine of Malta
Practice address
2388 Route 9
Suite 200
Mechancville, NY 12118
Phone
(518) 899-5390
Fax
(518) 899-5343
NPI assigned
Aug 8, 2006
Last updated
Oct 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Authorized official

Name
Marc D Price, DONPI 1346445194
Title
Family Physician
Phone
(518) 899-5390

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 219996 NY Primary

Addresses

Primary practice location

2388 Route 9
Suite 200
Mechancville, NY 12118

Mailing address

2388 Route 9
Suite 200
Mechancville, NY 12118
Phone (518) 899-5390

Other identifiers 1

IdentifierTypeStateIssuer
02312641MedicaidNY

Other names 1

  • Family Medicine of Malta Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051209000478 NY Part B Supplier - Clinic/Group Practice 8527089267 Receives reassigned benefits from 10 practitioners
Practice locations: Mechanicville, NY

National Provider Directory

National Provider Directory

Locations

2299 Route 9
Mechanicville, NY 12118
Phone (518) 899-5390

2388 Route 9
Ste 200
Mechanicville, NY 12118
Phone (518) 899-5390

Practitioners & affiliated clinicians

Practitioners 12

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": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1902816473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2388 ROUTE 9",
            "address_2": "SUITE 200",
            "city": "MECHANCVILLE",
            "state": "NY",
            "postal_code": "12118",
            "telephone_number": "518-899-5390",
            "fax_number": "518-899-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2388 ROUTE 9",
            "address_2": "SUITE 200",
            "city": "MECHANCVILLE",
            "state": "NY",
            "postal_code": "12118",
            "telephone_number": "518-899-5390",
            "fax_number": "518-899-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC D PRICE DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "FAMILY PHYSICIAN",
        "authorized_official_telephone_number": "518-899-5390",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "219996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02312641",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine of Malta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.