DR. JUSTIN A. PROVOST (NPI# 1588806608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588806608 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN A. PROVOST |
| Credential | M.D. |
| Practice Address |
848 Route 50 Burnt Hills NY 12027 |
| Mailing Address |
848 Route 50 Burnt Hills NY 12027-9511 |
| Practice Telephone | 5188311500 |
| Practice Fax Number | 5182808464 |
| Mailing Telephone | 5188311500 |
| Mailing Fax Number | 5182808464 |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2018-05-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | GME PERMIT | CT | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | R2077 | KY | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
278649 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
848 ROUTE 50 |
| City | BURNT HILLS |
| State | NY |
| Zip Code | 12027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952305203 | Arthur H Ostrov | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2005-06-02 |
| 1437648078 | Stephanie M Burwell | Nurse Practitioner | 848 Route 50, Burnt Hills, NY 12019 | 2018-05-09 |
| 1447784343 | Nicole Marie Morroni | Nurse Practitioner | 848 Route 50, Burnt Hills, NY 12027 | 2017-04-18 |
| 1801265947 | Kathleen R Cornell | Nurse Practitioner | 848 Route 50, Burnt Hills, NY 12027 | 2015-09-18 |
| 1104141209 | Zachary A Feinberg | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2010-03-31 |
| 1396989869 | Chad M. Cornish | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2009-04-28 |
| 1285808618 | Shawn A Chaudhary | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2008-04-16 |
| 1316122823 | Mark John Metwally | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2008-01-03 |
| 1144347451 | William M Gusten | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2007-03-23 |
| 1063599652 | Amy L Hettrich | Physician Assistant | 848 Route 50, Burnt Hills, NY 12027 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891005120 | Stephanie Triolo Holley | Occupational Therapist | 18 Townley Drive, Burnt Hills, NY 12027 | 2010-10-20 |
| 1861515652 | Richard Brian Lamanna | Dentist | 818 Saratoga Road, Burnt Hills, NY 12027 | 2007-04-09 |
| 1871691584 | Cvs Albany LLC | Durable Medical Equipment & Medical Supplies | 120 Lake Hill Rd, Burnt Hills, NY 12027 | 2006-09-20 |
| 1659477172 | Laurie Anne Delucia Fearman | Dentist | 105 Lake Hill Road., Burnt Hills, NY 12027 | 2006-09-15 |
| 1811279375 | Joseph P Denning | Dentist | 163 Lake Hill Rd, Burnt Hills, NY 12027 | 2011-09-12 |
| 1336296078 | The Charlton School | Residential Treatment Facility, Emotionally Disturbed Children | 322 Lakehill Rd., Burnt Hills, NY 12027-0047 | 2007-01-04 |
| 1437333838 | Kristen Cameron | Technician/Technologist | 793 Rt. 50, Burnt Hills, NY 12027-0209 | 2007-12-20 |
| 1043452626 | David Bruce Cameron | Technician/Technologist | 793 Rt. 50, Burnt Hills, NY 12027-0209 | 2009-03-30 |
| 1629175062 | Saratoga Schenectady Endoscopy Center, LLC | Clinic/Center | 848 Rt. 50, Burnt Hills, NY 12027-0419 | 2006-09-20 |
| 1851658827 | Saratoga Schenectady Gastroenterology Associates, P.C. | Internal Medicine | 846 Route 50, Bldg 1, Burnt Hills, NY 12027-0569 | 2012-04-16 |
| Find all providers in zip 12027 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851658827 | Saratoga Schenectady Gastroenterology Associates, P.C. | Internal Medicine | 846 Route 50, Bldg 1, Burnt Hills, NY 12027-0569 | 2012-04-16 |
| 1952305203 | Arthur H Ostrov | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2005-06-02 |
| 1104141209 | Zachary A Feinberg | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2010-03-31 |
| 1396989869 | Chad M. Cornish | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2009-04-28 |
| 1285808618 | Shawn A Chaudhary | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2008-04-16 |
| 1316122823 | Mark John Metwally | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2008-01-03 |
| 1144347451 | William M Gusten | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2007-03-23 |
| 1669566089 | David H Goetz | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2006-10-02 |
| 1093724767 | Saratoga Schenectady Gastroenterology Associates, PC | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027-0569 | 2006-08-05 |
| 1225057441 | Vinay Sood | Internal Medicine | 848 Route 50, Burnt Hills, NY 12027 | 2006-07-19 |
| Find all providers in BURNT HILLS | ||||
| City | BURNT HILLS |
| Zip Code | 12027 |
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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.