DR. LISA R BEVILACQUA (NPI# 1336231844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336231844 |
| Entity Type | Individual |
| Full Name | DR. LISA R BEVILACQUA |
| Credential | D.O. |
| Practice Address |
1882 New Scotland Rd Ste 200 Slingerlands NY 12159-3627 |
| Mailing Address |
711 Troy Schenectady Rd Ste 203 Latham NY 12110-2461 |
| Practice Telephone | 5184392460 |
| Mailing Telephone | 5187823700 |
| Mailing Fax Number | 5187823799 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2019-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 191889 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | AETNA | 531715 | 01 |
| NY | FIDELIS | 040824000041 | 01 |
| NY | MVP | 08954 | 01 |
| NY | CDPHP | 10005959 | 01 |
| NY | EMPIRE BC | 4725D1 | 01 |
| NY | GHI/HMO | 52558 | 01 |
| NY | 01495192 | 05 | |
| NY | BSNENY | 000401405003 | 01 |
| NY | SENIOR WHOLE HEALTH | 200032 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1240 New Scotland Rd, Suite 203, Slingerlands, NY 121599222 | 5184392460 | 5184393025 |
| 315 S Manning Blvd, Albany, NY 122081707 | 5185251550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497054340 | Lisa Bevilacqua | Acupuncturist | 241 Carroll St, Brooklyn, NY 11231-4603 | 2011-03-17 |
| 1659868651 | Lisa Andrea Bevilacqua | Student in an Organized Health Care Education/Training Program | 1015 Walnut St Ste 620, Philadelphia, PA 19107-5005 | 2018-04-16 |
| Street Address |
1882 NEW SCOTLAND RD STE 200 |
| City | SLINGERLANDS |
| State | NY |
| Zip Code | 12159-3627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396393203 | Sarah M.a. O'leary | Nurse Practitioner | 1882 New Scotland Rd Ste 200, Slingerlands, NY 12159-3627 | 2019-09-04 |
| 1437632767 | Kyle Andrew Nolan | Nurse Practitioner | 1882 New Scotland Rd Ste 200, Slingerlands, NY 12159-3627 | 2018-09-12 |
| 1033558853 | Gs Internal Medicine Pllc | Internal Medicine | 1882 New Scotland Rd Ste 200, Slingerlands, NY 12159-3627 | 2013-06-15 |
| 1134356512 | George Fayk Melad Soryal | Internal Medicine | 1882 New Scotland Rd Ste 200, Slingerlands, NY 12159-3627 | 2009-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649795667 | Jennifer Bannigan | Dietitian, Registered | 46 Daniel St, Slingerlands, NY 12159 | 2017-08-10 |
| 1477009082 | Miranda Alfred Lamorte | Occupational Therapy Assistant | 301 Highgate Drive, Slingerlands, NY 12159 | 2016-09-01 |
| 1083043814 | Robert George Westphal | Internal Medicine | 268 Font Grove Rd., Slingerlands, NY 12159 | 2013-11-02 |
| 1750624987 | Valerie Chen | Ophthalmology | 1220 New Scotland Rd Ste 302, Slingerlands, NY 12159 | 2013-04-06 |
| 1568707222 | St. Peter's Health Partners Medical Associates, P.C. | Physician Assistant | 1240 New Scotland Rd Suite 205, Suite 205, Slingerlands, NY 12159 | 2012-12-06 |
| 1235374166 | Joseph Concodora Farrell | Pharmacist | 1395 New Scotland Rd #176, Price Chopper Pharmacy, Slingerlands, NY 12159 | 2008-12-05 |
| 1720232747 | Michele Lynn Ryan | Community Health Worker | 43 Staffords's Xing, Slingerlands, NY 12159 | 2008-11-05 |
| 1396818027 | Virginia M Lazaro | Internal Medicine | 834 Kenwood Avenue, Slingerlands, NY 12159 | 2006-11-17 |
| 1477656080 | Michelene Sohnen | Speech-Language Pathologist | 334 Krumkill Road, Slingerlands, NY 12159 | 2006-09-07 |
| 1235231168 | Margaret Mary Grogan | Internal Medicine | 1525 New Scotland Rd, Slingerlands, NY 12159 | 2006-09-01 |
| Find all providers in zip 12159 | ||||
| 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 |
|---|---|---|---|---|
| 1003905480 | Peter H Forman | Family Medicine | 1499 New Scotland Rd, Slingerlands, NY 12159-9209 | 2006-10-12 |
| 1154390151 | Philip T. Drew, Md | Family Medicine | 1345 New Scotland Rd, Slingerlands, NY 12159-7216 | 2006-03-14 |
| 1235127796 | Andrew J Sullivan | Family Medicine | 34 N Helderberg Pkwy, Slingerlands, NY 12159-9258 | 2005-10-10 |
| 1023015625 | Edward Jerome Degnan | Family Medicine | 125 Kennewyck Cir, Slingerlands, NY 12159-9564 | 2005-06-29 |
| 1356619092 | Community Care Physicians, PC | Family Medicine | 1882 New Scotland Rd, Suite 200, Slingerlands, NY 12159-3627 | 2011-12-08 |
| 1932482890 | Community Care Physicians, PC | Family Medicine | 1882 New Scotland Rd, Suite 200, Slingerlands, NY 12159-3627 | 2011-09-27 |
| 1073686069 | St. Peter's Hospital of The City of Albany | Family Medicine | 1240 New Scotland Road, Suite 100, Slingerlands, NY 12159-9221 | 2006-11-16 |
| 1194814574 | Rebecca Elliott | Family Medicine | 1499 New Scotland Rd, Slingerlands, NY 12159-9209 | 2006-10-12 |
| 1437194966 | Debra C Zimring | Family Medicine | 1240 New Scotland Rd Ste 203, Slingerlands, NY 12159-9222 | 2006-06-18 |
| 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 | SLINGERLANDS |
| Zip Code | 12159 |
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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.