COMMUNITY CARE PHYSICIANS, PC (NPI# 1881047819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881047819 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE PHYSICIANS, PC |
| Other Organization Name | IMAGECARE PARK SOUTH |
| Practice Address |
391 Myrtle Ave Suite 4d Albany NY 12208-3513 |
| Mailing Address |
711 Troy Schenectady Rd Suite 203 Latham NY 12110-2442 |
| Practice Telephone | 5182072280 |
| Practice Fax Number | 5182072281 |
| Mailing Telephone | 5187823700 |
| Mailing Fax Number | 5187823799 |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |
| Authorized Official Name | DIANE M STAMAS (SENIOR CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 5187823742 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
248413 | NY | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| ImageCare Park South | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073025888 | Community Care Physicians, PC | Surgery | 2520 Riverfront Ctr, Amsterdam, NY 12010-4614 | 2017-11-02 |
| 1255853065 | Community Care Physicians, PC | Family Medicine | 711 Troy Schenectady Rd Ste 109, Latham, NY 12110-2454 | 2017-07-13 |
| 1760808018 | Community Care Physicians, PC | Radiology | One Norton Avenue, Radiology Department Ao Fox Memorial Hospital, Oneonta, NY 13820 | 2014-03-11 |
| 1780956474 | Community Care Physicians, PC | Obstetrics & Gynecology | 5 Southside Dr, Suite 204, Clifton Park, NY 12065-3870 | 2012-01-27 |
| 1285905786 | Community Care Physicians, PC | Internal Medicine | 199 Delaware Ave, Delmar, NY 12054-1229 | 2012-01-16 |
| 1487937348 | Community Care Physicians, PC | Pediatrics | 3732 Carman Rd., Schenectady, NY 12303-5422 | 2011-09-27 |
| 1841573706 | Community Care Physicians, PC | Pediatrics | 942 A Route 146, Clifton Park, NY 12605-3614 | 2011-09-27 |
| 1104109065 | Community Care Physicians, PC | Internal Medicine | 2546 Balltown Road, Suite 200, Schenectady, NY 12309-1079 | 2011-09-27 |
| 1275816548 | Community Care Physicians, PC | Pediatrics | 6 Executive Park Drive, Albany, NY 12203-3791 | 2011-09-23 |
| 1093097586 | Community Care Physicians, PC | Family Medicine | 2524 Us Route 9w, Ravena, NY 12143-2804 | 2011-09-12 |
| Street Address |
391 MYRTLE AVE SUITE 4D |
| City | ALBANY |
| State | NY |
| Zip Code | 12208-3513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457344012 | Judith Anne Lucas | Pediatrics | 391 Myrtle Ave, Suite 3b, Albany, NY 12208 | 2005-08-29 |
| 1073144325 | Kathryn Souder | Social Worker | 391 Myrtle Ave, Albany, NY 12208-3835 | 2020-01-27 |
| 1699322461 | Stephanie Gagnon | Genetic Counselor, MS | 391 Myrtle Ave, Albany, NY 12208-3835 | 2019-08-26 |
| 1235667940 | Sahar Bilal | Student in an Organized Health Care Education/Training Program | 391 Myrtle Ave, Albany, NY 12208-3835 | 2017-05-24 |
| 1700337789 | Maria Kimberly Noakes | Counselor | 391 Myrtle Ave, Albany, NY 12208-3835 | 2016-10-14 |
| 1417300443 | Community Care Physicians, PC | Family Medicine | 391 Myrtle Ave, Suite 4d, Albany, NY 12208-3835 | 2016-07-14 |
| 1467801332 | Albany Medical College | Neurological Surgery | 391 Myrtle Ave, Suite 1b, Albany, NY 12208-3513 | 2016-06-10 |
| 1710394051 | Alison M Joseph | Nurse Practitioner | 391 Myrtle Ave, Neurosurgery Clinic, Albany, NY 12208-3835 | 2014-07-18 |
| 1356760342 | Nora Callinan | Family Medicine | 391 Myrtle Ave, Suite 4a, Albany, NY 12208-3835 | 2014-04-07 |
| 1609214394 | Joanne Virginia Dannenhoffer | Family Medicine | 391 Myrtle Ave, Suite 4a, Albany, NY 12208-3513 | 2013-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959045 | Fatima Mahmood | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Department of Internal Medicine, Albany, NY 12208 | 2020-07-08 |
| 1861021784 | Jessica Anne Charles-larose | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Family Medicine, Albany, NY 12208 | 2020-04-02 |
| 1235767211 | Michael Charles Harrington | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Orthopedic Surgery, Albany, NY 12208 | 2020-03-27 |
| 1518594126 | Arkar Htoo | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Pathology, Albany, NY 12208 | 2020-03-24 |
| 1366079030 | Omar Merdan | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept of Medicine/pediatrics, Albany, NY 12208 | 2020-03-24 |
| 1306473079 | Sergo Gabunia | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of General Surgery, Albany, NY 12208 | 2020-03-24 |
| 1205469392 | Cornell Andre Morris | Social Worker | Albany Stratton Va Medical Center, 113 Holland Avenue, Albany, NY 12208 | 2020-02-17 |
| 1558909234 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 310, Capital Region Colon & Rectal Surgery, Albany, NY 12208 | 2019-12-13 |
| 1912543265 | Meghan Rose Baxter | Social Worker | 58 Academy Rd., Albany, NY 12208 | 2019-11-21 |
| 1245883461 | Gwendolyn Medak | Registered Nurse | 15 New Scotland Ave, Albany, NY 12208 | 2019-07-17 |
| Find all providers in zip 12208 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962846956 | Anthony Edward Lang | Radiology | 17 Colonial Ave, Albany, NY 12203-2009 | 2013-04-22 |
| 1073881157 | Frank Maynard Thames Jr. | Radiology | 2219 Golf Course Dr, Albany, GA 31721-2079 | 2011-12-05 |
| 1487934188 | Maurice Emile Marchand | Radiology | 43 New Scotland Ave, Dept of Radiology, Albany Medical Center Hospital, Albany, NY 12208 | 2011-08-25 |
| 1285926709 | Marco Diego Vitto | Radiology | 47 New Scotland Ave Dept Of, Albany, NY 12208-3412 | 2011-05-03 |
| 1629368519 | Joseph M Rozell | Radiology | 255 Patroon Creek Blvd Apt 3439, Albany, NY 12206 | 2011-04-12 |
| 1235377334 | Douglas George Walled | Radiology | 315 So Manning Blvd, Sph Medical Imaging, Albany, NY 12208 | 2009-01-27 |
| 1922203413 | John Ronald Andrews | Radiology | 2205 West Doublegate Drive, Albany, GA 31721 | 2007-06-15 |
| 1942402110 | Michael Brooks Whiteside | Radiology | 1365 Washington Ave Ste 103, Albany, NY 12206-1098 | 2007-06-01 |
| 1255415063 | Gary Siskin | Radiology | Albany Medical Center Hospital, 47 New Scotland Ave - Radiology, Albany, NY 12208 | 2006-10-25 |
| 1639268956 | Royce Marlin Cannington IIi | Radiology | 2715 Mccall Ct, Albany, GA 31721-9194 | 2006-10-12 |
| Find all providers in ALBANY | ||||
Please comment or provide details below to improve the information on COMMUNITY CARE PHYSICIANS, PC.
| 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.