OSWEGO FAMILY PHYSICIANS PC (NPI# 1629489588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629489588 |
| Entity Type | Organization |
| Organization Name | OSWEGO FAMILY PHYSICIANS PC |
| Other Organization Name | OSWEGO FAMILY PHYSICIANS |
| Practice Address |
110 W Utica St Oswego NY 13126-3047 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 3153422024 |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-05-14 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 231144 | NY | Suppliers |
| Other Name | Type Code |
|---|---|
| Oswego Family Physicians | Doing Business As Name - Organization |
| Street Address |
110 W UTICA ST |
| City | OSWEGO |
| State | NY |
| Zip Code | 13126-3047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740247493 | Jessica Marie Digby | Physician Assistant | 110 W Utica St, Oswego, NY 13126-3047 | 2006-04-27 |
| 1154630366 | Bobbie Rae Faivus Vangorder | Physician Assistant | 110 W Utica St, Oswego, NY 13126-3047 | 2010-10-05 |
| 1659450989 | Douglas Paul Guenter | Emergency Medicine | 110 W Utica St, Oswego, NY 13126-3047 | 2006-11-06 |
| 1477567493 | Robert F Schaefer Jr. | Dentist | 110 W Utica St, Oswego, NY 13126-3047 | 2006-07-27 |
| 1831126648 | Mark Anthony Humphrey | Family Medicine | 110 W Utica St, Oswego, NY 13126-3057 | 2006-06-27 |
| 1891721957 | Robert Charles Morgan | Family Medicine | 110 W Utica St, Oswego, NY 13126-3057 | 2006-06-23 |
| 1659317980 | Micheal D Stephens | Family Medicine | 110 W Utica St, Oswego, NY 13126-3057 | 2006-06-22 |
| 1477506996 | Oswego Family Physicians, PC | Medical Genetics, Ph.D. Medical Genetics | 110 W Utica St, Oswego, NY 13126-3057 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303572 | Elise Fitzsimmons | Specialist/Technologist | 9 Laker Hall, Oswego, NY 13126 | 2020-10-15 |
| 1023651742 | Jessica Lynn Metzger | Physician Assistant | 300 Ny-104 Suite 1, Oswego, NY 13126 | 2019-10-25 |
| 1245887009 | Maureen Adams | Technician | 30 Stone Ridge Drive, Oswego, NY 13126 | 2019-08-26 |
| 1285128314 | Justin Raymond Beebe | Nurse Practitioner | 300 State Route 104 Ste 2, Oswego, NY 13126 | 2018-06-21 |
| 1801311220 | Lynne M Wallace | Registered Nurse | 29 Birch Lane 17b, Oswego, NY 13126 | 2017-08-07 |
| 1497203962 | Lindsay Cheslock | Local Education Agency (LEA) | 529 County Route 25, Oswego, NY 13126 | 2016-09-14 |
| 1942757919 | Aimee Devinny | Registered Nurse | 21 Twin Orchard Drive, Oswego, NY 13126 | 2016-09-07 |
| 1083160295 | Cameron Delmotte | Specialist | 159 West Frist Street, Oswego, NY 13126 | 2016-08-28 |
| 1508319187 | Samantha Thayer | Occupational Therapist | 159 West First Oswego St, Oswego, NY 13126 | 2016-07-29 |
| 1104279595 | Vikram Jala | Internal Medicine | 105 County Route 45a Ste 400, Oswego, NY 13126 | 2016-07-20 |
| Find all providers in zip 13126 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.