DOREEN PEREZ MONDELO (NPI# 1174830863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174830863 |
| Entity Type | Individual |
| Full Name | DOREEN PEREZ MONDELO |
| Credential | M.D. |
| Practice Address |
400 Patroon Creek Blvd Ste 100 Albany NY 12206-5014 |
| Mailing Address |
Po Box 14890 Albany NY 12212-4890 |
| Practice Telephone | 5186181100 |
| Mailing Telephone | 5185255634 |
| Mailing Fax Number | 5186494094 |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2020-01-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 265445 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | AETNA | 9635885 | 01 |
| NY | 03464019 | 05 | |
| NY | FIDELIS | 120821000140 | 01 |
| NY | EMPIRE BCBS | 187YS1 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2125 River Rd, 202, Schenectady, NY 123091135 | 5183469682 | 5183469693 |
| Street Address |
400 PATROON CREEK BLVD STE 100 |
| City | ALBANY |
| State | NY |
| Zip Code | 12206-5014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629060819 | Stefan A Swicker | Internal Medicine | 400 Patroon Creek Blvd Ste 100, Albany, NY 12206 | 2005-08-16 |
| 1730560764 | Diana Malinowski | Physician Assistant | 400 Patroon Creek Blvd Ste 100, Albany, NY 12206-5014 | 2015-06-16 |
| 1851535561 | Jamie Lynn Young | Nurse Practitioner | 400 Patroon Creek Blvd Ste 100, Albany, NY 12206-5014 | 2009-04-24 |
| 1821109992 | Deborah Ann Hildreth | Physician Assistant | 400 Patroon Creek Blvd Ste 100, Albany, NY 12206-5014 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144749854 | Madena Lynn Henderson | Licensed Practical Nurse | 51 Garfield Pl, Albany, NY 12206 | 2017-09-13 |
| 1912456534 | Adeel A Janjua I | Contractor | 17 Roosevelt St, Albany, NY 12206 | 2016-09-23 |
| 1376901595 | Jacqueline Aimee Dall | Nurse Practitioner | 855 Central Avenue, Albany, NY 12206 | 2016-02-02 |
| 1326414210 | Sarah Walton | Pharmacist | 346 Central Ave, Albany, NY 12206 | 2015-08-14 |
| 1376932558 | Hope House, Inc. | Substance Abuse Rehabilitation Facility | 577 Livingston Ave., Albany, NY 12206 | 2015-01-12 |
| 1679993828 | Lori S. Matulewicz | Nurse Practitioner | 500 Central Ave., Equinox, Inc., Albany, NY 12206 | 2014-04-25 |
| 1437417995 | Ernest Nicola Chisena | Orthopaedic Surgery | 1367 Washington Avenue Suite 200, Albany, NY 12206 | 2012-05-02 |
| 1629368519 | Joseph M Rozell | Radiology | 255 Patroon Creek Blvd Apt 3439, Albany, NY 12206 | 2011-04-12 |
| 1346542404 | Melissa June Kowlessar | Licensed Practical Nurse | 69 Benson Street, Albany, NY 12206 | 2010-11-23 |
| 1316109796 | Edmund John Mcgrath | Podiatrist | 911 Central Avenue #24, Albany, NY 12206 | 2008-06-27 |
| Find all providers in zip 12206 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1407492796 | American Ecare | Family Medicine | 3 Computer Dr W Ste 107, Albany, NY 12205-1621 | 2019-11-21 |
| 1124678347 | Carehere LLC | Family Medicine | Carehere Clinic- City of Albany, Ga, 2000 North Monroe Street, Albany, GA 31701 | 2019-09-19 |
| 1790332831 | Granland3 LLC | Family Medicine | 2622 Dawson Rd, Albany, GA 31707-1609 | 2019-08-22 |
| 1295397065 | Cerrito Creek Family Medicine Inc | Family Medicine | 400 Evelyn Ave., St. 107, Albany, CA 94706 | 2019-07-02 |
| 1487190526 | Tracey Anyanwu | Family Medicine | 539 N Westover Blvd, 133, Albany, GA 31707-1951 | 2017-01-12 |
| 1275911828 | St Claire Gitau Sumaili | Family Medicine | 2403 Osler Ct Ste A, Albany, GA 31707-0205 | 2015-05-15 |
| 1235516071 | Daniel Barton Mosher | Family Medicine | 2605 Willetta St Sw Ste D1, Albany, OR 97321-3481 | 2015-04-30 |
| 1508129214 | Alan Shifman Charles | Family Medicine | 741 Gateview Ave, Albany, CA 94706-1029 | 2012-06-18 |
| 1770840324 | Joseph A Kelly | Family Medicine | 27 Park Ln E, #2, Albany, NY 12204-1960 | 2012-04-20 |
| Find all providers in ALBANY | ||||
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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.