ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC (NPI# 1255871828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255871828 |
| Entity Type | Organization |
| Organization Name | ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC |
| Practice Address |
279 Troy Road Family Medical Group Rensselaer NY 12144-9518 |
| Mailing Address |
Po Box 14890 St. Peter's Health Partners Payer Credentialing Albany NY 12212-4890 |
| Practice Telephone | 5182861922 |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |
| Authorized Official Name | JANICE MACKE (CFO) |
| Authorized Official Telephone | 5185255634 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133N00000X | Nutritionist | Dietary & Nutritional Service Providers | ||
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821535592 | St. Peter's Health Partners Medical Associates, PC | General Practice | 713 Troy Schenectady Rd Ste 304, St. Peter's Ob/gyn At Latham, Latham, NY 12110-2490 | 2017-01-19 |
| 1629512876 | St. Peter's Health Partners Medical Associates, PC | Nurse Practitioner | 582 New Loudon Road, Latham, NY 12110-5707 | 2016-12-07 |
| 1265983530 | St. Peter's Health Partners Medical Associates, PC | General Practice | 2 New Hampshire Avenue, Capital Region Diabetes & Endocrine Care, Troy, NY 12180-1764 | 2016-10-20 |
| 1982062261 | St. Peter's Health Partners Medical Associates, PC | Family Medicine | 377 Church Street, Saratoga, NY 12866 | 2016-02-02 |
| 1376092692 | St. Peter's Health Partners Medical Associates, PC | Surgery | 2 New Hampshire Ave, St. Peter's Bariatric Care, Troy, NY 12180-1764 | 2016-09-28 |
| 1083168603 | St. Peter's Health Partners Medical Associates, PC | Emergency Medicine | 400 Patroon Creek Blvd, Suite 100, Albany, NY 12206-5013 | 2016-08-11 |
| 1093160822 | St. Peter's Health Partners Medical Associates, PC | Family Medicine | 2 Empire Dr, Rensselaer, NY 12144-5730 | 2016-04-29 |
| 1457706731 | St. Peter's Health Partners Medical Associates, PC | Psychiatry & Neurology | 63 Shaker Road, Suite G01, Albany, NY 12204-1030 | 2016-04-25 |
| 1720441215 | St. Peter's Health Partners Medical Associates, PC | Internal Medicine | 55 Mohawk St, Suite 105, Cohoes, NY 12047-2629 | 2016-04-01 |
| 1083031983 | St. Peter's Health Partners Medical Associates, PC | Nurse Practitioner | 4 Palisades Dr, Suite 200a, Albany, NY 12205-1443 | 2014-03-28 |
| Street Address |
279 TROY ROAD FAMILY MEDICAL GROUP |
| City | RENSSELAER |
| State | NY |
| Zip Code | 12144-9518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376636910 | Keith Alan Rebehn | Family Medicine | 279 Troy Road, Rensselaer, NY 12144 | 2006-10-02 |
| 1518360635 | Elizabeth Devereux | Nurse Practitioner | 279 Troy Road, Family Medical Group, Rensselaer, NY 12144-9756 | 2014-10-02 |
| 1811244684 | Samaritan Hospital of Troy, New York | Internal Medicine | 279 Troy Road, Rensselaer, NY 12144 | 2012-08-10 |
| 1760578603 | Fredrick Bruce Cunningham | Physician Assistant | 279 Troy Road, Rensselaer, NY 12144 | 2006-10-05 |
| 1831283548 | Nicole Ryan | Physician Assistant | 279 Troy Road, Rensselaer, NY 12144 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053955567 | Sherisa Moore | Registered Nurse | 17 River Chase Drive, B, Rensselaer, NY 12144 | 2019-10-29 |
| 1811553738 | Joel C Campbell | Licensed Practical Nurse | 419 Northgreenbush Road, Rensselaer, NY 12144 | 2019-05-16 |
| 1063956688 | Ashley F Bertorelli | Physical Therapist | 476 N Greenbush Rd Ste 3, Rensselaer, NY 12144 | 2016-12-16 |
| 1184066060 | Stefanie L Walsh | Physical Therapist | 2 Empire Dr Ste 202, Rensselaer, NY 12144 | 2013-07-22 |
| 1821347550 | C & L Transport Inc. | Non-emergency Medical Transport (VAN) | 27 Columbia Street, Rensselaer, NY 12144 | 2012-09-10 |
| 1639448376 | Harry William Letko | Licensed Practical Nurse | 456b North Greenbush Rd, Rensselaer, NY 12144 | 2011-12-27 |
| 1285901827 | Tammy Ellen Barbour | Registered Nurse | 25 Vanrensselaer Dr., Rensselaer Academy, Rensselaer, NY 12144 | 2011-11-28 |
| 1144474693 | Peter Patrick Martin | Occupational Therapist | 24 Oak Street, Rensselaer, NY 12144 | 2008-11-11 |
| 1487820064 | Kathleen Powell | Pharmacist | 501 Columbia Turnpike, Price Chopper, Rensselaer, NY 12144 | 2008-05-05 |
| 1609065788 | Stefan J Fosco | Audiologist | 2 Empire Dr Ste 204, Rensselaer, NY 12144 | 2007-10-15 |
| Find all providers in zip 12144 | ||||
| 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 |
|---|---|---|---|---|
| 1780168740 | Samaritan Hospital of Troy, New York | Family Medicine | 2 Empire Drive, Suite 100, Rensselaer, NY 12144-5730 | 2018-09-17 |
| 1558626309 | Alina Nazar | Family Medicine | 2 Empire Dr Ste 100, Rensselaer, NY 12144-5730 | 2012-07-09 |
| 1669534962 | Stuart A Sandler | Family Medicine | 919 Grace Street, Rensselaer, IN 47978 | 2006-12-14 |
| 1487725750 | St. Peter's Hospital of The City of Albany | Family Medicine | 53 Columbia Street, Rensselaer, NY 12144-2933 | 2006-11-10 |
| 1376636910 | Keith Alan Rebehn | Family Medicine | 279 Troy Road, Rensselaer, NY 12144 | 2006-10-02 |
| 1528175676 | Steven R Beaver | Family Medicine | 919 E Grace St, Rensselaer, IN 47978-3207 | 2006-08-24 |
| 1396704268 | Patrick J Sheets | Family Medicine | 208 W Washington St, Rensselaer, IN 47978-2848 | 2006-03-20 |
| 1851370563 | Dulay & Dulay Md PC | Family Medicine | 223 Broadway, Rensselaer, NY 12144 | 2006-01-11 |
| 1649266180 | Stephen Charles Spicer | Family Medicine | 1103 E Grace St, Rensselaer, IN 47978-3210 | 2005-09-20 |
| 1609879675 | Stephen Kyle Rogers | Family Medicine | 716 S College Ave, Rensselaer, IN 47978-3083 | 2005-05-24 |
| Find all providers in RENSSELAER | ||||
| City | RENSSELAER |
| Zip Code | 12144 |
Please comment or provide details below to improve the information on ST. PETER'S 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.