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MOUNTAIN MEDICAL PEDIATRICS
NPI 1821210352
Specialist in Saranac Lake, NY

Active since May 03, 2007
1927 SARANAC AVE, SARANAC LAKE, NY 12983(518) 523-7575 Get Directions Write a Review

NPPES record last updated: February 18, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mountain Medical Pediatrics NPPES

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

MOUNTAIN MEDICAL PEDIATRICS (NPI 1821210352) is a healthcare organization registered as a specialist in Saranac Lake, New York and active in the NPI registry since May 2007. The organization lists Keri Wallace, M.d., as its authorized official.

NPPES Registry Identity

NPI1821210352
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameMOUNTAIN MEDICAL PEDIATRICS
Location Address1927 SARANAC AVESaranac Lake, NY 12983
Mailing Address1927 Saranac AveSaranac Lake, NY 12983
Phone(518) 523-7575
Organization SubpartNo
Authorized OfficialKeri WallaceM.d. · (518) 523-7575
Enumeration DateMay 3, 2007
Last NPPES UpdateFebruary 18, 2008
✔ NPI 1821210352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 236345
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

1927 SARANAC AVE, Saranac Lake, NY 12983
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Other Identifiers 2

Medicare ID-Type UnspecifiedBA0289NY
Medicaid02752954NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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

Mountain Medical Service Urgent Care · Lake Placid, NY
Expired · Jun 8, 2026
CLIA Number33D1022055
Laboratory TypePhysician Office
Certificate Effective DateJune 9, 2024
Certificate Expiration DateJune 8, 2026
Laboratory DirectorDr. Michael Pond
Laboratory Phone(518) 523-7575
Laboratory LocationMountain Medical Service Urgent Care1927 Saranac Avenue, Suite 100, Lake Placid, NY 12946
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

What is MOUNTAIN MEDICAL PEDIATRICS's NPI number?

The NPI number assigned to this healthcare provider is 1821210352, enumerated as an "organization" on May 03, 2007.

Where is the provider located?

The provider is located at 1927 SARANAC AVE SARANAC LAKE, NY 12983 and the phone number is (518) 523-7575.

What is the provider's specialty?

Specialist with taxonomy code 174400000X.

What insurance does MOUNTAIN MEDICAL PEDIATRICS accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.