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LANSINGBURGH FAMILY PRACTICE, PC
NPI 1710931837
Family Medicine in Troy, NY

Active since May 22, 2006CLIA 33D1022923 · Waiver
595 5TH AVE, TROY, NY 12182(518) 235-8034(518) 235-8036 Get Directions Write a Review

NPPES record last updated: January 30, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jan 30, 2020, Apr 11, 2018 (2 updates tracked since 2018).

About Lansingburgh Family Practice, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LANSINGBURGH FAMILY PRACTICE, PC (NPI 1710931837) is a healthcare organization registered as a family medicine in Troy, New York and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through March 27, 2027 and lists Adetona B Adetona, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1710931837
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLANSINGBURGH FAMILY PRACTICE, PC
Location Address595 5TH AVETroy, NY 12182-2501
Mailing Address595 5th AveTroy, NY 12182-2501 · (518) 235-8034 · Fax (518) 235-8036
Phone(518) 235-8034
Fax(518) 235-8036
Organization SubpartNo
Authorized OfficialAdetona B AdetonaMd/owner · (518) 235-8034
Enumeration DateMay 22, 2006
Last NPPES UpdateJanuary 30, 20202 updates tracked since enumeration
✔ NPI 1710931837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 2056621
Definition
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.
595 5TH AVE, Troy, NY 12182
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lansingburgh Family Practice, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Lansingburgh Family Practice, PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Adetutu Adetona, M.D.
Family Practice
NPI 1629038930
595 5TH AVE
Troy, NY 12182
(518) 235-8034
✔ PECOS✔ Accepts MedicareSame address
Rahmat Gul
Nurse Practitioner
NPI 1699443911
595 5TH AVE
Troy, NY 12182
(518) 235-8034
✔ PECOS✔ Accepts MedicareSame address
Leshaun Angmor, F.N.P
Nurse Practitioner
NPI 1063874550
315 2ND AVE SUITE 2
Troy, NY 12182
(518) 235-8034
✔ PECOS0.8 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1022923

Lansingburgh Family Practice PC · Troy, NY
Active · expires Mar 27, 2027
CLIA Number33D1022923
Laboratory TypePhysician Office
Certificate Effective DateMarch 28, 2025
Certificate Expiration DateMarch 27, 2027
Laboratory DirectorDr. Adetutu B. Adetona
Laboratory Phone(518) 235-8034
Laboratory LocationLansingburgh Family Practice PC595 5th Avenue, Troy, NY 12182
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lansingburgh Family Practice, PC's NPI number?

The NPI number for Lansingburgh Family Practice, PC is 1710931837. It was assigned to this organization in the NPPES registry on May 22, 2006.

Where is Lansingburgh Family Practice, PC located?

Lansingburgh Family Practice, PC is located at 595 5th Ave, Troy, NY 12182. The listed phone number is (518) 235-8034.

What is Lansingburgh Family Practice, PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lansingburgh Family Practice, PC enrolled in Medicare?

Yes. Lansingburgh Family Practice, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lansingburgh Family Practice, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Lansingburgh Family Practice, PC, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lansingburgh Family Practice, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1022923) is associated with this NPI, valid through March 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lansingburgh Family Practice, PC was last updated on January 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.