| Carondelet Regional Medical, Pc | |
| 
					3768 State Highway 30 Broadalbin Health Center Broadalbin NY 12025-0923  | |
| (518) 883-3121 | |
| (518) 883-8268 | 
| Full Name | Carondelet Regional Medical, Pc | 
|---|---|
| Speciality | General Practice | 
| Location | 3768 State Highway 30, Broadalbin, New York | 
| Authorized Official Name and Position | Ronald N Marsh (PRESIDENT) | 
| Authorized Official Contact | 5188436914 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Carondelet Regional Medical, Pc 427 Guy Park Ave Amsterdam NY 12010-1064 Ph: (518) 841-7401  | Carondelet Regional Medical, Pc 3768 State Highway 30 Broadalbin Health Center Broadalbin NY 12025-0923 Ph: (518) 883-3121  | 
| NPI Number | 1861939944 | 
|---|---|
| Provider Enumeration Date | 01/26/2017 | 
| Last Update Date | 05/22/2023 | 
| Medicare PECOS PAC ID | 0840554051 | 
|---|---|
| Medicare Enrollment ID | O20180515002257 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1861939944 | NPI | - | NPPES | 
| Provider Name | Craig E Todd | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1033170873 PECOS PAC ID: 7012902646 Enrollment ID: I20040414001841  | 
| Provider Name | David A Robinson | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1053340489 PECOS PAC ID: 8123095122 Enrollment ID: I20040910000233  | 
| Provider Name | Craig N Van Roekens | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1710930615 PECOS PAC ID: 1557253127 Enrollment ID: I20041117000922  | 
| Provider Name | James F Forrest | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1336183292 PECOS PAC ID: 6204891849 Enrollment ID: I20041123000743  | 
| Provider Name | Linda S Selby | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1639165251 PECOS PAC ID: 9537112578 Enrollment ID: I20050302000092  | 
| Provider Name | Martin P. Kasofsky | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1598783722 PECOS PAC ID: 4183665284 Enrollment ID: I20050519000142  | 
| Provider Name | Susan Casler Bladek | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1558395418 PECOS PAC ID: 9830108935 Enrollment ID: I20060420000419  | 
| Provider Name | Walter D Cummings | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1790982478 PECOS PAC ID: 1355439738 Enrollment ID: I20071119000376  | 
| Provider Name | Ronald Marsh | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1932219367 PECOS PAC ID: 2860485968 Enrollment ID: I20080425000262  | 
| Provider Name | Robert M Droege | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1164423489 PECOS PAC ID: 0042210056 Enrollment ID: I20100518000066  | 
| Provider Name | William H Forlano | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1114928413 PECOS PAC ID: 1951301969 Enrollment ID: I20100518000089  | 
| Provider Name | George G Weis | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1457352999 PECOS PAC ID: 2860492873 Enrollment ID: I20100518000117  | 
| Provider Name | William D Mayer | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1518963941 PECOS PAC ID: 5890960819 Enrollment ID: I20111202000286  | 
| Provider Name | Kevin P Cope | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1861498248 PECOS PAC ID: 1759298425 Enrollment ID: I20111202000310  | 
| Provider Name | Nicole D Santiago | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1730527458 PECOS PAC ID: 8123254091 Enrollment ID: I20131125000204  | 
| Provider Name | Christopher J Mierek | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1790911931 PECOS PAC ID: 2567438617 Enrollment ID: I20140211001161  | 
| Provider Name | Jeri Lynne Savoie | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1003010786 PECOS PAC ID: 5698908614 Enrollment ID: I20140429000059  | 
| Provider Name | Julie Martin | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1740658244 PECOS PAC ID: 2062713357 Enrollment ID: I20151210000262  | 
| Provider Name | Jesse J Hollis | 
|---|---|
| Provider Type | Practitioner - General Surgery | 
| Provider Identifiers | NPI Number: 1669755112 PECOS PAC ID: 7719274497 Enrollment ID: I20160923000429  | 
| Provider Name | Chelsea Elizabeth Sohns | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1598422164 PECOS PAC ID: 9537550322 Enrollment ID: I20220105002609  | 
| Provider Name | Heather Lynn Miner-goetz | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1366105389 PECOS PAC ID: 9739575978 Enrollment ID: I20220415000125  | 
| Provider Name | Crystal Maria Burnsby | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1205391489 PECOS PAC ID: 8527413251 Enrollment ID: I20231016001132  | 
| Provider Name | Govind C K Rao | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1225146574 PECOS PAC ID: 5193251007 Enrollment ID: I20241216000172  | 
| Provider Name | Tara Lynn Mccoll | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1952143208 PECOS PAC ID: 9931639994 Enrollment ID: I20250206001956  | 
Mayer And Cope Family Practice Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3768 State Highway 30, Broadalbin, NY 12025 Phone: 518-883-3121  | |
Carondelet Regional Medical, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3768 State Highway 30, Broadalbin, NY 12025 Phone: 518-883-3121 Fax: 518-883-8268  |