ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PC (NPI# 1104257252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104257252 |
| Entity Type | Organization |
| Organization Name | ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PC |
| Practice Address |
10 Gagnon Dr Stone Ridge NY 12484-5120 |
| Practice Telephone | 5486877455 |
| Mailing Telephone | 5486877455 |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2014-07-21 |
| Authorized Official Name | PAUL GORDON (CFO) |
| Authorized Official Telephone | 5185251585 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811328966 | St. Peters Health Partners Medical Associates PC | Emergency Medicine | 11 Hempstead Place, Suite 103, Saratoga Springs, NY 12866 | 2013-11-27 |
| 1639504699 | St. Peters Health Partners Medical Associates PC | Internal Medicine | 433 River Street Suite 3000, Troy, NY 12180 | 2013-09-10 |
| 1770970675 | St. Peters Health Partners Medical Associates PC | Physician Assistant | 2 Empire Dr, East Greenbush Ultrasound, Rensselaer, NY 12144-5730 | 2015-04-20 |
| 1831586809 | St. Peters Health Partners Medical Associates PC | Radiology | 713 Troy Schenectady Rd, Suite 304, Latham, NY 12110-2490 | 2015-04-17 |
| 1750778726 | St. Peters Health Partners Medical Associates PC | Radiology | 2 Empire Dr, Rensselaer, NY 12144-5730 | 2015-04-17 |
| 1205223294 | St. Peters Health Partners Medical Associates PC | Radiology | 147 Hoosick Street, Troy, NY 12180-2353 | 2015-04-17 |
| 1245628361 | St. Peters Health Partners Medical Associates PC | Surgery | 319 S Manning Blvd, Suite 304, Albany, NY 12208-1742 | 2014-12-23 |
| 1417362963 | St. Peters Health Partners Medical Associates PC | Family Medicine | 854 Route 212, Saugerties, NY 12477-4619 | 2014-06-24 |
| 1154744753 | St. Peters Health Partners Medical Associates PC | Psychiatry & Neurology | 279 Troy Rd, Rensselaer, NY 12144-9518 | 2014-02-03 |
| 1174954606 | St. Peters Health Partners Medical Associates PC | Nurse Practitioner | 319 South Manning Blvd, Suite C364, Albany, NY 12208-1742 | 2013-12-10 |
| Street Address |
10 GAGNON DR |
| City | STONE RIDGE |
| State | NY |
| Zip Code | 12484-5120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669464624 | Peter James Petrulis | Family Medicine | 10 Gagnon Dr, Stone Ridge, NY 12484-5120 | 2005-08-16 |
| 1073966560 | Donaldson & Chiera, Rn, Family Health Np, P.C. | Clinic/Center | 10 Gagnon Dr, Stone Ridge, NY 12484-5120 | 2016-07-20 |
| 1679514004 | Rondout Valley Family Med PC | Physician Assistant | 10 Gagnon Dr, Stone Ridge, NY 12484-5120 | 2006-06-09 |
| 1649247438 | Elizabeth M Gregory | Family Medicine | 10 Gagnon Dr, Stone Ridge, NY 12484 | 2006-03-01 |
| 1023092723 | Robert J Taylor | Family Medicine | 10 Gagnon Dr, Stone Ridge, NY 12484-5120 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669964706 | Hurley Avenue Family Medicine | Family Medicine | 10 Gagnon Dr., Stone Ridge, NY 12484 | 2018-06-05 |
| 1053691014 | Helena Nikolajevic | Acupuncturist | 24 Albright Lane, Stone Ridge, NY 12484 | 2011-08-23 |
| 1346532090 | Stone Ridge Chiropractic, PC | Chiropractor | 3631 Main Street, Stoneridge, NY 12484 | 2011-05-12 |
| 1760681829 | Elizabeth S Loughren | Registered Nurse | 766 Old Turnpike Rd, In Care of Dr Wm Thomas, Sherburne, NY 12484 | 2007-07-17 |
| 1457472789 | Sondra D. Tillou | Chiropractor | Rt. 209 & Mt. View, Stone Ridge, NY 12484 | 2007-04-03 |
| 1336269539 | Renee Gabrielle Sabin-haggerty | Pharmacist | 3852 Main St, Rite Aid Store #10704, Stone Ridge, NY 12484 | 2007-03-30 |
| 1114028818 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 3852 Main Street, Stone Ridge, NY 12484 | 2006-09-26 |
| 1417967530 | Wayne William St Hill | Dentist | 10 Gagnon Drive, Rte 209, Stone Ridge, NY 12484 | 2006-08-09 |
| 1902897242 | Timothy E Deschenes | Chiropractor | Box 514, 3631 Main Street, Stone Ridge, NY 12484 | 2005-11-04 |
| 1023388147 | Alicia Ann Marquis-serson | Speech-Language Pathologist | 122 Kyserike Road, Stone Ridge, NY 12484 | 2012-01-05 |
| Find all providers in zip 12484 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669964706 | Hurley Avenue Family Medicine | Family Medicine | 10 Gagnon Dr., Stone Ridge, NY 12484 | 2018-06-05 |
| 1396235537 | Chatman Inc | Family Medicine | 42010 Village Center Plz Ste 100, Stone Ridge, VA 20105-3036 | 2018-05-14 |
| 1669464624 | Peter James Petrulis | Family Medicine | 10 Gagnon Dr, Stone Ridge, NY 12484-5120 | 2005-08-16 |
| 1730187642 | Anita Shabnam Chatman | Family Medicine | 42010 Village Center Plz, Suite # 100, Stone Ridge, VA 20105-3032 | 2005-07-13 |
| 1649247438 | Elizabeth M Gregory | Family Medicine | 10 Gagnon Dr, Stone Ridge, NY 12484 | 2006-03-01 |
| 1023092723 | Robert J Taylor | Family Medicine | 10 Gagnon Dr, Stone Ridge, NY 12484-5120 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295558 | Mamoon Malik | Family Medicine | 90 Menands Rd, Albany, NY 12204-1400 | 2020-11-08 |
| 1336749571 | Chowdhury Medical PC | Family Medicine | 155 Alkier St, Brentwood, NY 11717-5129 | 2020-10-27 |
| 1356940084 | Rebecca Jean Smouse | Family Medicine | 1107 Prendergast Ave, Jamestown, NY 14701-3315 | 2020-10-23 |
| 1336748136 | Rapha House Calls | Family Medicine | 2 Fernglade Ct, Chester, NY 10918-2637 | 2020-10-22 |
| 1174122980 | Richmond Health Partners Ipa LLC | Family Medicine | 1161 Victory Blvd, Staten Island, NY 10301-3621 | 2020-10-22 |
| 1730787128 | Michael C Secallus | Family Medicine | 66 Kirkwood Gdns, Kirkwood, NY 13795-1623 | 2020-10-16 |
| 1861099053 | Julia Gross Family Health Nurse Practitioner, Pllc | Family Medicine | 950 Route 146 Ste 100, Clifton Park, NY 12065-3667 | 2020-10-01 |
| 1013523190 | Steinway Hope Medical LLC | Family Medicine | 8829 54th Ave Fl 2, Elmhurst, NY 11373-4543 | 2020-09-23 |
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1992319016 | Sarah Glaser | Family Medicine | 30 W 24th St, New York, NY 10010-3207 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | STONE RIDGE |
| Zip Code | 12484 |
Please comment or provide details below to improve the information on ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PC.
| 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.