ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C. (NPI# 1285061721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285061721 |
| Entity Type | Organization |
| Organization Name | ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C. |
| Other Organization Name | CAPITAL REGION UROLOGY |
| Practice Address |
63 Shaker Rd Ste 202 Albany NY 12204-1030 |
| Mailing Address |
Po Box 14890 Albany NY 12212-4890 |
| Practice Telephone | 5184341283 |
| Mailing Telephone | 5185255634 |
| Mailing Fax Number | 5186494094 |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2019-12-12 |
| Authorized Official Name | COURTNEY KNOWLES (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 5185255634 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2088F0040X |
Urology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03539695 | 05 |
| Other Name | Type Code |
|---|---|
| Capital Region Urology | Doing Business As Name - Organization |
| Capital Region Urology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548738 | St. Peter's Health Partners Medical Associates, P.C. | Internal Medicine | 2546 Balltown Road Suite 300, Cardiology Associates of Schenectady, Schenectady, NY 12309-1079 | 2020-11-03 |
| 1477176634 | St. Peter's Health Partners Medical Associates, P.C. | Clinic/Center | 1301 River Street Suite 202, St. Peter's Obgyn At Valatie, Valatie, NY 12184-8696 | 2020-05-22 |
| 1558909234 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 310, Capital Region Colon & Rectal Surgery, Albany, NY 12208 | 2019-12-13 |
| 1881179646 | St. Peter's Health Partners Medical Associates, P.C. | Family Medicine | 2109 15th Street, Troy, NY 12180 | 2018-09-27 |
| 1295211365 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 110b, Albany, NY 12208-1744 | 2018-07-12 |
| 1992227714 | St. Peter's Health Partners Medical Associates, P.C. | Dietitian, Registered | 319 South Manning Blvd Suite 307, Albany, NY 12208 | 2017-07-13 |
| 1922550011 | St. Peter's Health Partners Medical Associates, P.C. | Nutritionist | 2 New Hampshire Ave Ste 200, Troy, NY 12180-1762 | 2016-10-25 |
| 1427394675 | St. Peter's Health Partners Medical Associates, P.C. | Midwife | 31 Lower Hudson Avenue, Green Island, NY 12183-1014 | 2012-12-17 |
| 1083959738 | St. Peter's Health Partners Medical Associates, P.C. | Physical Medicine & Rehabilitation | 1444 Western Ave Ste A, Albany, NY 12203-3458 | 2012-12-06 |
| 1629313382 | St. Peter's Health Partners Medical Associates, P.C. | Family Medicine | 1301 River Street Suite 204, Chatham Internal Medicine, Valatie, NY 12184-8696 | 2012-12-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C. | Att: President, 315 S. Manning Blvd, Albany, Ny 12208 |
| Street Address |
63 SHAKER RD STE 202 |
| City | ALBANY |
| State | NY |
| Zip Code | 12204-1030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568015352 | Chanel Bovian | Licensed Practical Nurse | 587 Broadway Apt.a2, Menands, NY 12204 | 2019-07-20 |
| 1659853513 | David Jonathan Brown | Driver | 456 North Pearl St., Albany, NY 12204 | 2018-09-06 |
| 1255686481 | Adam Michael Burman | Pharmacist | 350 Northern Boulevard, Albany, NY 12204 | 2012-07-13 |
| 1043579196 | Victoria Epstein | Ophthalmology | 63 Shaker Rd Ste 101, Albany, NY 12204 | 2012-05-10 |
| 1306117270 | Jacqueline J Swenson | Physical Therapist | Albany Memorial Hospital, 600 Northern Blvd, Albany, NY 12204 | 2012-01-24 |
| 1730466681 | Kathleen C Dalcol | Registered Nurse | 570 North Pearl Street, North Albany Academy, Albany, NY 12204 | 2011-11-07 |
| 1649592049 | Shirley L Savage | Licensed Practical Nurse | 150 Broadway Ave., Suite 310, Menands, NY 12204 | 2010-02-26 |
| 1801084645 | The Embryology Network | Clinical Medical Laboratory | 600 Northern Blvd., Albany Memorial Hospital, Albany, NY 12204 | 2007-10-05 |
| 1124248430 | Prime Care Physicians, P.l.l.c. | Internal Medicine | 63 Albany Shaker Road, Suite 102, Albany, NY 12204 | 2007-04-27 |
| 1578788204 | Antoinette June Holman | Licensed Practical Nurse | Riverview Center 150 Broadway, Suite 6e, Albany, NY 12204 | 2007-04-16 |
| Find all providers in zip 12204 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235525916 | William Kelvin Lane | Urology | 2009 Palmyra Rd, Albany, GA 31701-1576 | 2015-04-09 |
| 1962586776 | Mark White | Urology | The Urological Institute of Northeastern New York, South Clinical Campus, 23 Hackett Blvd., Albany, NY 12208 | 2006-10-25 |
| 1225118284 | Hugh Fisher | Urology | South Clinical Campus, 23 Hackett Blvd. (mc 208), Albany, NY 12208 | 2006-10-16 |
| 1174625693 | Keith A Schulze | Urology | 400 Hickory St Nw Ste 200, Albany, OR 97321-1700 | 2006-09-04 |
| 1497790430 | Martin S Engelstein | Urology | 4 Executive Park, Albany, NY 12203-3718 | 2006-06-16 |
| 1912967241 | Donald Joseph Rivard | Urology | 25 Hackett Blvd, Division of Urology (mc 208), Albany, NY 12208-3420 | 2006-03-23 |
| 1811964430 | Barry A Shuman | Urology | 63 Shaker Rd Suite 202, Albany Memorial Professional Bldg, Albany, NY 12204-1030 | 2006-03-02 |
| 1932175924 | Sophia Drinis | Urology | 400 Hickory St Nw, Suite 200, Albany, OR 97321-1700 | 2006-02-28 |
| 1811983711 | Carl Robert Hall | Urology | 920 8th Ave Sw, Albany, OR 97321-2407 | 2005-09-26 |
| 1467447938 | Michael D. Daugherty | Urology | 2400 Osler Ct, Albany, GA 31707 | 2005-09-12 |
| 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.