NPIMap

Organization Active NPI

Carondelet Regional Medical, PC

  • Family Medicine Physician
  • Broadalbin, NY
National Provider Identifier
1972296630
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CARONDELET REGIONAL MEDICAL, PC
Practice address
3768 State Highway 30
Broadalbin, NY 12025-0923
Phone
(518) 883-3121
Fax
(518) 883-8268
NPI assigned
May 30, 2023
Last updated
May 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CARONDELET REGIONAL MEDICAL, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Authorized official

Name
Ronald N Marsh, MD
Title
Authorized Official
Phone
(518) 843-6914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

3768 State Highway 30
Broadalbin, NY 12025-0923

Mailing address

3768 State Highway 30
Broadalbin, NY 12025-0923
Phone (518) 883-3121

National Provider Directory

National Provider Directory
Tax ID family
Carondelet Regional Medical PC2 organizations share this tax ID, including this one
Part of
Carondelet Regional Medical PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1685404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1972296630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3768 STATE HIGHWAY 30",
            "city": "BROADALBIN",
            "state": "NY",
            "postal_code": "120250923",
            "telephone_number": "518-883-3121",
            "fax_number": "518-883-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3768 STATE HIGHWAY 30",
            "city": "BROADALBIN",
            "state": "NY",
            "postal_code": "120250923",
            "telephone_number": "518-883-3121",
            "fax_number": "518-883-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARONDELET REGIONAL MEDICAL, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARONDELET REGIONAL MEDICAL, PC",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "518-843-6914",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broadalbin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.