Individual provider Active NPI

Desiree Joyce Mollnow, FNP-BC

  • Family Nurse Practitioner
  • Latham, NY
National Provider Identifier
1912632027
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349893 Issued in NY
Practice address
410 Troy Schenectady Rd Ste 203
Latham, NY 12110-3254
Phone
(518) 503-3047
Fax
(518) 467-8302
NPI assigned
Jul 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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 349893 NY Primary

Addresses

Primary practice location

410 Troy Schenectady Rd Ste 203
Latham, NY 12110-3254

Mailing address

410 Troy Schenectady Rd Ste 203
Latham, NY 12110-3254
Phone (518) 503-3047

Other names 1

  • Desiree Joyce Giroux Former name

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
I20220919001192 NY Practitioner - Nurse Practitioner 0042695652 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
349893NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC CurrentSince Aug 8, 2022 Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

35 Empire State Blvd
Castleton on Hudson, NY 12033
Phone (518) 477-2167

713 Troy Schenectady Rd
Ste 224
Latham, NY 12110
Phone (518) 785-3614

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

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

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1912632027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 TROY SCHENECTADY RD STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121103254",
            "telephone_number": "518-503-3047",
            "fax_number": "518-467-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 TROY SCHENECTADY RD STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121103254",
            "telephone_number": "518-503-3047",
            "fax_number": "518-467-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLNOW",
        "first_name": "DESIREE",
        "middle_name": "JOYCE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESIREE",
            "last_name": "GIROUX",
            "middle_name": "JOYCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.