Individual provider Active NPI

Ellen Regal, NP

  • Family Nurse Practitioner
  • Delmar, NY
National Provider Identifier
1912427881
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
341894 Issued in NY
Practice address
250 Delaware Ave Ste 100
Delmar, NY 12054-1402
Phone
(518) 459-8077
Fax
(518) 459-8070
NPI assigned
Jun 22, 2017
Last updated
Jun 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 341894 NY Primary

Addresses

Primary practice location

250 Delaware Ave Ste 100
Delmar, NY 12054-1402

Mailing address

711 Troy Schenectady Rd Ste 203
Latham, NY 12110-2461
Phone (518) 782-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170825001381 NY Practitioner - Nurse Practitioner 5799057758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

6 Wellness Way
Latham, NY 12110-2156
Phone (518) 782-3700

711 Troy Schenectady Rd
Latham, NY 12110-2461

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
341894NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC CurrentSince Jul 31, 2017 Accepting new patients

Locations

250 Delaware Ave
Ste 100
Delmar, NY 12054
Phone (518) 439-8077

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 237-7363

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

Interoperability endpoints

  • Direct secure messaging: ellenregal@ccp.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1912427881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 DELAWARE AVE STE 100",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541402",
            "telephone_number": "518-459-8077",
            "fax_number": "518-459-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAL",
        "first_name": "ELLEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delmar, NY

Sources for this page

Verify at the official NPI Registry.