KOINONIA PRIMARY CARE INC (NPI# 1023389533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023389533 |
| Entity Type | Organization |
| Organization Name | KOINONIA PRIMARY CARE INC |
| Other Organization Name | KOINONIA PRIMARY MEDICAL CARE PC |
| Practice Address |
553 Clinton Ave Albany NY 12206-2738 |
| Practice Telephone | 5186890282 |
| Practice Fax Number | 5186890283 |
| Mailing Telephone | 5186890282 |
| Mailing Fax Number | 5186890283 |
| Enumeration Date | 2012-01-16 |
| Last Update Date | 2012-01-16 |
| Authorized Official Name | DR. ROBERT JOHN PAEGLOW (PRESIDENT) |
| Authorized Official Telephone | 5186890282 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | NY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Koinonia Primary Medical Care PC | Former Legal Business Name - Organization |
| Street Address |
553 CLINTON AVE |
| City | ALBANY |
| State | NY |
| Zip Code | 12206-2738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508891243 | Deborah Leadholm Kriss | Pediatrics | 553 Clinton Ave, Koinonia Health Care, Albany, NY 12206-2738 | 2006-07-11 |
| 1134738040 | Elaine Ho | Nurse Practitioner | 553 Clinton Ave, Albany, NY 12206-2738 | 2020-07-27 |
| 1912550658 | Rachel Lynn Siffring | Family Medicine | 553 Clinton Ave, Albany, NY 12206-2738 | 2019-07-22 |
| 1750634242 | Cathleen Whitmore Svenson | Nurse Practitioner | 553 Clinton Ave, Albany, NY 12206-2738 | 2012-10-21 |
| 1578834081 | Resurrection Ministries | Clinic/Center | 553 Clinton Ave, Albany, NY 12206-2738 | 2012-01-16 |
| 1316133689 | Susan M Austin Md Pllc | Psychiatry & Neurology | 553 Clinton Ave, Albany, NY 12206-2738 | 2007-09-20 |
| 1366568123 | Susan K Richter | Psychiatry & Neurology | 553 Clinton Ave, Albany, NY 12206-2738 | 2007-03-22 |
| 1568576379 | Robert John Paeglow | Family Medicine | 553 Clinton Ave, Albany, NY 12206-2738 | 2006-08-18 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1881755601 | Upper Hudson Planned Parenthood Inc. | Clinic/Center | 855 Central Ave., Albany, NY 12206 | 2006-12-13 |
| 1154406221 | Pearl Street Counseling Center, Inc. | Clinic/Center | 109 State St, Albany, NY 12207-1622 | 2006-10-26 |
| 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.