Organization Active NPI

Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
National Provider Identifier
1922048370
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMMUNITY CARE PHYSICIANS, PLLC
Practice address
6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone
(518) 782-3700
Fax
(518) 782-3799
NPI assigned
Jun 7, 2006
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY CARE PHYSICIANS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Diane Marie Stamas
Title
Credentialing Coordinator
Phone
(518) 782-3742

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

6 Wellness Way Ste 201
Latham, NY 12110-2156

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, MD, NC, MO, FL, DC, SC, GA, CA, PA11 enrollments

Enrollment records 11

Enrollment IDStateProvider typePAC IDDetails
O20080130000272 NY Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 536 practitioners
O20160318000104 NJ Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 2 practitioners
Practice locations: Jobstown, NJ; Teaneck, NJ
O20171019001730 MD Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 2 practitioners
Practice locations: Dayton, MD
O20190809000396 NC Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 2 practitioners
Practice locations: Durham, NC
O20200520001869 MO Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO
O20210823000247 FL Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 3 practitioners
Practice locations: Boynton Beach, FL; North Port, FL; West Palm Beach, FL
O20230313002755 DC Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 1 practitioner
Practice locations: Falls Church, VA
O20230424000589 SC Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 1 practitioner
Practice locations: Simpsonville, SC
O20231017001846 GA Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 3 practitioners
Practice locations: Atlanta, GA; Marietta, GA; Columbus, GA
O20240226000201 CA Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 2 practitioners
Practice locations: Anaheim, CA; Sunnyvale, CA
O20240321001336 PA Part B Supplier - Clinic/Group Practice 8022904473 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory
Part of
Deborah Aberdale NP

Locations (25 of 84)

2 Clara Barton Dr
Ste 114
Albany, NY 12208
Phone (518) 459-5273

2 Clara Barton Dr
Ste 201
Albany, NY 12208
Phone (518) 207-2273

23 Hackett Blvd
Albany, NY 12208
Phone (518) 262-3296

23 Hackett Blvd
Ste 103
Albany, NY 12208
Phone (518) 446-0391

319 S Manning Blvd
Ste 114
Albany, NY 12208
Phone (518) 270-7700

391 Myrtle Ave
#4C
Albany, NY 12208

391 Myrtle Ave
Ste 4C
Albany, NY 12208
Phone (518) 207-2299

411 New Karner Rd
Albany, NY 12205
Phone (518) 608-6329

501 New Karner Rd
Ste 1
Albany, NY 12205
Phone (518) 393-0391

501 New Karner Rd
Ste 1A
Albany, NY 12205
Phone (518) 393-0391

5 Hemphill Pl
Ste 12
Ballston Spa, NY 12020

61 Rowland St
Ballston Spa, NY 12020
Phone (518) 232-1759

1184 State Route 50
Burnt Hills, NY 12019
Phone (518) 384-1281

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

81 Miller Rd
Ste 800
Castleton on Hudson, NY 12033
Phone (518) 477-2167

286 Stage Rd
Charlton, NY 12019
Phone (518) 399-2101

939 Route 146
Ste 700
Clifton Park, NY 12065
Phone (518) 383-0891

942A Route 146
Clifton Park, NY 12065
Phone (518) 371-8000

963 Route 146
Clifton Park, NY 12065
Phone (518) 383-0065

199 Delaware Ave
Delmar, NY 12054
Phone (518) 439-1131

200 Delaware Ave
Ste 100
Delmar, NY 12054

250 Delaware Ave
Ste 201
Delmar, NY 12054
Phone (518) 690-0789

5 Elm Ave
#2
Delmar, NY 12054
Phone (518) 439-9363

6 Mountain Ledge
Gansevoort, NY 12831
Phone (518) 584-0335

6 Mountain Ledge
Ste 1
Gansevoort, NY 12831
Phone (518) 584-0355

Practitioners & affiliated clinicians

Practitioners 678

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.

View all 678

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1922048370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "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": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PHYSICIANS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CARE PHYSICIANS, PLLC",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "STAMAS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "518-782-3742"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 27, 2024; 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.