ST. PETER'S HOSPITAL OF THE CITY OF ALBANY (NPI# 1194943670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194943670 |
| Entity Type | Organization |
| Organization Name | ST. PETER'S HOSPITAL OF THE CITY OF ALBANY |
| Other Organization Name | ST. PETER'S ADDICTION RECOVERY CENTER |
| Practice Address |
636 New Loudon Road Latham NY 12110-4002 |
| Mailing Address |
Po Box 14890 Albany NY 12212-4890 |
| Practice Telephone | 5187835381 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2019-12-26 |
| Authorized Official Name | COURTNEY KNOWLES (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 5185255634 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282N00000X | General Acute Care Hospital | 0101004H | NY | Hospitals |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
0101004H | NY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SPARC | Other Name - Individual/Organization |
| St. Peter's Addiction Recovery Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245682442 | St. Peter's Hospital of The City of Albany | Nurse Practitioner | 1 Pine West Plaza, Washington Ave Ext., Suite 101, Albany, NY 12205-5537 | 2016-07-12 |
| 1598982548 | St. Peter's Hospital of The City of Albany | Family Medicine | 125 High Rock Ave, Saratoga Springs, NY 12866-2307 | 2007-04-19 |
| 1669698601 | St. Peter's Hospital of The City of Albany | Family Medicine | 64 2nd Avenue, Albany, NY 12202-1240 | 2007-04-18 |
| 1487725750 | St. Peter's Hospital of The City of Albany | Family Medicine | 53 Columbia Street, Rensselaer, NY 12144-2933 | 2006-11-10 |
| 1689184830 | St. Peter's Hospital of The City of Albany | Family Medicine | 315 South Manning Blvd, Labor and Delivery, Albany, NY 12208-1707 | 2017-10-02 |
| 1982141537 | St. Peter's Hospital of The City of Albany | Psychologist | 315 South Manning Blvd, Albany, NY 12208-1707 | 2017-01-20 |
| 1144407024 | St. Peter's Hospital of The City of Albany | Physician Assistant | 317 South Manning Blvd, Suite 220, Albany, NY 12208-1738 | 2008-01-23 |
| 1265508659 | St. Peter's Hospital of The City of Albany | Nurse Practitioner | 315 South Manning Blvd, Albany, NY 12208-1707 | 2006-11-28 |
| 1548336936 | St. Peter's Hospital of The City of Albany | Obstetrics & Gynecology | 1240 New Scotland Road, Slingerlands, NY 12159-9276 | 2006-11-28 |
| 1073686069 | St. Peter's Hospital of The City of Albany | Family Medicine | 1240 New Scotland Road, Suite 100, Slingerlands, NY 12159-9221 | 2006-11-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST. PETER'S HOSPITAL OF THE CITY OF ALBANY | 315 S Manning Blvd, Albany, NY 12208-1707 |
| New York State Corporations | ST. PETER'S HOSPITAL OF THE CITY OF ALBANY | 28 Liberty Street, New York, New York 10005 |
| Street Address |
636 NEW LOUDON ROAD |
| City | LATHAM |
| State | NY |
| Zip Code | 12110-4002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154963973 | Bayley Archinal | Physical Therapist | 711 Troy-schenectady Road, Ste 216, Latham, NY 12110 | 2019-10-14 |
| 1114410701 | Kimberly A. Hostig Licensed Clinical Social Worker Pllc | Clinic/Center | 8 Stanley Cir Ste 11, Latham, NY 12110 | 2018-06-08 |
| 1710477260 | Colleen Phillips | Physical Therapist | 711 Troy Schenectady Rd Ste 216, Latham, NY 12110 | 2018-05-10 |
| 1528574779 | Deborah Cannon | Specialist | 33c Waterford Avenue East, Latham, NY 12110 | 2017-12-26 |
| 1730600149 | Michael Navarrete | Dentist | 231 Wade Road Ext Unit 101, Latham, NY 12110 | 2017-07-06 |
| 1316499452 | Colonie Asc LLC | Clinic/Center | 207 Troy-schenectady Rd, Colonie, NY 12110 | 2016-10-25 |
| 1720539950 | Tania M Durante | Pharmacist | 1057 Troy-schenectady Rd, Latham, NY 12110 | 2016-10-24 |
| 1417344987 | New York Epilepsy Medicine, PC | Clinic/Center | 3 Lear Jet Ln Ste 203, Latham, NY 12110 | 2015-04-22 |
| 1346664752 | Lauren Gannon | Registered Nurse | 95 Forts Ferry Road, Latham, NY 12110 | 2014-02-06 |
| 1649522756 | Natasha Kapsaroff-ruiz | Nurse Practitioner | 654 Watervliet Shaker Rd, Latham, NY 12110 | 2012-10-12 |
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| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1093074825 | Community Counseling & Mediation | Clinic/Center | 367 E 7th St, Brooklyn, NY 11218-4105 | 2012-05-14 |
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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.