Individual provider Active NPI

Karen K. Michelena, M.D.

  • Family Medicine Physician
  • Galway, NY
National Provider Identifier
1962582262
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
233388 Issued in NY
Practice address
5344 Sacandaga Rd
Galway, NY 12074-2422
Phone
(518) 882-6955
Fax
(518) 886-5880
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 233388 NY Primary

Addresses

Primary practice location

5344 Sacandaga Rd
Galway, NY 12074-2422

Mailing address

5344 Sacandaga Rd
Galway, NY 12074-2422
Phone (518) 882-6955

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050714000341 NY Practitioner - Family Practice 4082640610 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital Family Medicine CurrentSince Nov 30, 2015 Accepting new patients
Saratoga Hospital Family Medicine Current Accepting new patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital Current Accepting new patients
Union Street Family Medicine, LLC Family Medicine PastSince Oct 17, 2005 Accepting new patients

Locations

3050 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5108

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

Organizations & group practices 5

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1962582262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5344 SACANDAGA RD",
            "city": "GALWAY",
            "state": "NY",
            "postal_code": "120742422",
            "telephone_number": "518-882-6955",
            "fax_number": "518-886-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5344 SACANDAGA RD",
            "city": "GALWAY",
            "state": "NY",
            "postal_code": "120742422",
            "telephone_number": "518-882-6955",
            "fax_number": "518-886-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELENA",
        "first_name": "KAREN",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "233388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galway, NY

Sources for this page

Verify at the official NPI Registry.