ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C. (NPI# 1487081923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487081923 |
| Entity Type | Organization |
| Organization Name | ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C. |
| Other Organization Name | CAPITAL REGION UROLOGY |
| Practice Address |
319 S Manning Blvd Ste 106 Suite 106 Albany NY 12208-1743 |
| Mailing Address |
Po Box 14890 Albany NY 12212-4890 |
| Practice Telephone | 5184381019 |
| Mailing Telephone | 5185255634 |
| 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 | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| 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 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4 Executive Park Drive, 2nd Floor, Albany, NY 122033717 | 5184897494 | |
| 855 Route 146, Building B, Clifton Park, NY 120653885 | 5184897494 | |
| 4 Executive Park Dr, Albany, NY 122033718 | 5184897494 |
| 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 |
| 1285061721 | St. Peter's Health Partners Medical Associates, P.C. | Urology | 63 Shaker Rd Ste 202, Albany, NY 12204-1030 | 2013-09-30 |
| 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 |
| 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 |
319 S MANNING BLVD STE 106 SUITE 106 |
| City | ALBANY |
| State | NY |
| Zip Code | 12208-1743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659301422 | Linda L Davis | Nurse Practitioner | 319 S Manning Blvd Ste 106, Albany, NY 12208-1743 | 2006-07-04 |
| 1194353326 | Gabrielle Nicole Lounsbury | Physician Assistant | 319 S Manning Blvd Ste 106, Albany, NY 12208-1743 | 2020-04-01 |
| 1194358028 | Ling Yi Mei | Physician Assistant | 319 S Manning Blvd Ste 106, Albany, NY 12208-1743 | 2020-02-19 |
| 1295397503 | Lauren Judith Blair | Nurse Practitioner | 319 S Manning Blvd Ste 106, Albany, NY 12208-1743 | 2019-07-08 |
| 1366920969 | Allyson Elizabeth Eggan | Physician Assistant | 319 S Manning Blvd Ste 106, Albany, NY 12208 | 2018-08-06 |
| 1356894091 | Olga Kirk | Physician Assistant | 319 S Manning Blvd Ste 106, Albany, NY 12208-1743 | 2016-07-29 |
| 1619261542 | Suzanne Alexandra Mains | Nurse Practitioner | 319 S Manning Blvd Ste 106, Albany, NY 12208 | 2011-06-08 |
| 1831419514 | Maria Voznesensky | Urology | 319 S Manning Blvd Ste 106, Albany, NY 12208-1743 | 2010-06-04 |
| 1033223276 | Jonah Marshall | Urology | 319 S Manning Blvd Ste 106, Albany, NY 12208-1743 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959045 | Fatima Mahmood | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Department of Internal Medicine, Albany, NY 12208 | 2020-07-08 |
| 1861021784 | Jessica Anne Charles-larose | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Family Medicine, Albany, NY 12208 | 2020-04-02 |
| 1235767211 | Michael Charles Harrington | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Orthopedic Surgery, Albany, NY 12208 | 2020-03-27 |
| 1518594126 | Arkar Htoo | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Pathology, Albany, NY 12208 | 2020-03-24 |
| 1366079030 | Omar Merdan | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept of Medicine/pediatrics, Albany, NY 12208 | 2020-03-24 |
| 1306473079 | Sergo Gabunia | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of General Surgery, Albany, NY 12208 | 2020-03-24 |
| 1205469392 | Cornell Andre Morris | Social Worker | Albany Stratton Va Medical Center, 113 Holland Avenue, Albany, NY 12208 | 2020-02-17 |
| 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 |
| 1912543265 | Meghan Rose Baxter | Social Worker | 58 Academy Rd., Albany, NY 12208 | 2019-11-21 |
| 1245883461 | Gwendolyn Medak | Registered Nurse | 15 New Scotland Ave, Albany, NY 12208 | 2019-07-17 |
| Find all providers in zip 12208 | ||||
| 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 | ||||
Please comment or provide details below to improve the information on ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C..
| 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.