ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C. (NPI# 1497178099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497178099 |
| Entity Type | Organization |
| Organization Name | ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C. |
| Other Organization Name | ST. PETER'S CENTER FOR MS AND HEADACHE CARE |
| Practice Address |
63 Shaker Rd Ste G01 Albany NY 12204-1030 |
| Mailing Address |
Po Box 14890 Albany NY 12212-4890 |
| Practice Telephone | 5184292561 |
| Mailing Telephone | 5185255634 |
| Mailing Fax Number | 5186494094 |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2018-06-16 |
| 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 | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03539695 | 05 |
| Other Name | Type Code |
|---|---|
| St. Peter's Center for MS and Headache Care | Other Name - Individual/Organization |
| St. Peter's General Neurology | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 63 Shaker Rd Ste 102, Albany, NY 122041030 | 5184292561 |
| 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 |
63 SHAKER RD STE G01 |
| City | ALBANY |
| State | NY |
| Zip Code | 12204-1030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841546355 | Mai Mona Rasoully | Nurse Practitioner | 63 Shaker Rd Ste G01, Albany, NY 12204-1030 | 2012-08-02 |
| 1275927303 | Erica Hailey Parrotta | Psychiatry & Neurology | 63 Shaker Rd Ste G01, Albany, NY 12204-1030 | 2015-03-26 |
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790078608 | George Reeves Throop IIi | Psychiatry & Neurology | 1142 Nw Scenic Dr, Albany, OR 97321-9669 | 2011-05-25 |
| 1295927952 | Jennifer Durphy | Psychiatry & Neurology | 47 New Scotland Ave # Mc-70, Albany, NY 12208-3412 | 2007-08-15 |
| 1831396803 | Kalpesh Patel | Psychiatry & Neurology | 701 14th Ave, Albany, GA 31701-1301 | 2007-07-02 |
| 1720289168 | Farrukh Shaikh Md Pllc | Psychiatry & Neurology | 25 Park Dr, Albany, NY 12204-2243 | 2007-05-31 |
| 1033284625 | Magnolia Medical Center | Psychiatry & Neurology | 701 14th Avenue, Albany, GA 31701 | 2006-11-21 |
| 1245287234 | Francisco Javier Gomez | Psychiatry & Neurology | 110 Wolf Rd, Albany, NY 12205-1244 | 2006-05-27 |
| 1447206206 | Mindy Sanders | Psychiatry & Neurology | 760 Madison Ave, Albany, NY 12208-3428 | 2006-05-25 |
| 1750351862 | William T Garrett | Psychiatry & Neurology | 2709 Meredyth Dr Ste 230, Albany, GA 31707-0218 | 2006-01-23 |
| 1609863448 | New York Oncology Hematology, P.C. | Psychiatry & Neurology | 400 Patroon Creek Blvd., Suite 1, Albany, NY 12206-5014 | 2005-10-05 |
| 1679937338 | Gary Volkell | Psychiatry & Neurology | 47 New Scotland Ave Dept of Neurology, Albany, NY 12208-3412 | 2016-04-08 |
| 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.