ELLIS HOSPITAL (NPI# 1639659931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639659931 |
| Entity Type | Organization |
| Organization Name | ELLIS HOSPITAL |
| Other Organization Name | ELLIS PRIMARY CARE - CLIFTON PARK |
| Practice Address |
103 Sitterly Rd Ste 2300 Halfmoon NY 12065-5646 |
| Practice Telephone | 5185792650 |
| Mailing Telephone | 5185792650 |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |
| Authorized Official Name | PAUL A MILTON (CEO) |
| Authorized Official Telephone | 5182434175 |
| Is Organization Subpart | Y |
| Parent Organization Name | ELLIS HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
4601001H | NY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Ellis Primary Care - Clifton Park | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528548823 | Ellis Hospital | Clinic/Center | 200 Harborside Drive, Suite 101, Schenectady, NY 12305-1020 | 2018-08-16 |
| 1699255190 | Ellis Hospital | Clinic/Center | 624 Mcclellan St Ste 202, Schenectady, NY 12304-1020 | 2018-08-15 |
| 1871073353 | Ellis Hospital | Clinic/Center | 990 State Route 67 Ste 101, Ballston Spa, NY 12020-3603 | 2018-08-15 |
| 1972077386 | Ellis Hospital | Clinic/Center | 600 Mcclellan St, Schenectady, NY 12304-1009 | 2019-01-18 |
| 1548740848 | Ellis Hospital | Clinic/Center | 115 Saratoga Rd Ste 200, Glenville, NY 12302-4224 | 2018-08-16 |
| 1023598331 | Ellis Hospital | Clinic/Center | 624 Mcclellan St Ste G2, Schenectady, NY 12304-1024 | 2018-08-16 |
| 1013497502 | Ellis Hospital | Clinic/Center | 600 Mcclellan St, Schenectady, NY 12304 | 2018-08-15 |
| 1902386485 | Ellis Hospital | Clinic/Center | 624 Mcclellan St Ste 101, Schenectady, NY 12304-1020 | 2018-08-15 |
| 1881174381 | Ellis Hospital | Clinic/Center | 2537 Route 9, Suite 203, Malta, NY 12020 | 2018-08-15 |
| 1285114777 | Ellis Hospital | Clinic/Center | 1201 Nott St Ste 204, Schenectady, NY 12308 | 2018-08-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ELLIS HOSPITAL | 1101 Nott Street, Schenectady, Ny 12308 |
| New York State Corporations | ELLIS HOSPITAL FOUNDATION, INC. | 1101 Nott Street, Schenectady, Ny 12308 |
| Street Address |
103 SITTERLY RD STE 2300 |
| City | HALFMOON |
| State | NY |
| Zip Code | 12065-5646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104887884 | Michael Francis O'brien | Physician Assistant | 103 Sitterly Rd Ste 2300, Halfmoon, NY 12065 | 2006-03-31 |
| 1558775544 | Eliud Torres | Family Medicine | 103 Sitterly Rd Ste 2300, Halfmoon, NY 12065-5646 | 2014-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699395392 | Farah Malek | Pathology | 51 Heritage Point Drvie, Clifton Park, NY 12065 | 2020-04-22 |
| 1679116115 | Mary Beth Bulger | Registered Nurse | Shenendehowa Central School, 970 Rt 146, Clifton Park, NY 12065 | 2019-10-28 |
| 1346801636 | Terri Anne Willman | Physician Assistant | 1783 Route 9 Suite 102, Clifton Park, NY 12065 | 2019-06-26 |
| 1437633732 | Abhishek Chopra | Pharmacist | 74 Squire Lane, Clifton Park, NY 12065 | 2018-09-21 |
| 1295213817 | Ella Kotsyuba | Pharmacist | 1022 Ny-146, Clifton Park, NY 12065 | 2018-08-06 |
| 1659865962 | Dorothy Lacombe Adult Healthcare Nurse Practitioner Pllc | Internal Medicine | 954 Rt 146, Suite 3, Clifton Park, NY 12065 | 2018-06-20 |
| 1245723907 | Catherine Marie Blaauboer I | Licensed Practical Nurse | 206 Alnut Drive, Clifton Park, NY 12065 | 2018-06-07 |
| 1326530627 | Melissa Morgan | Physician Assistant | 29 Mann Blvd, Halfmoon, NY 12065 | 2018-06-01 |
| 1982101465 | Janelle Stannard | Occupational Therapist | 23 Sitterly Road, Clifton Park, NY 12065 | 2018-04-10 |
| 1962903831 | Clifton Park Asc LLC | Clinic/Center | 16 Maxwell Dr., Clifton Park, NY 12065 | 2018-02-26 |
| Find all providers in zip 12065 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1972159333 | Ap Medical Care PC | Clinic/Center | 3506 73rd St Ste 2, Jackson Heights, NY 11372-4104 | 2019-08-12 |
| 1982258422 | Schenk Primary Care Medicine, Pllc | Clinic/Center | 2350 Maple Road Suite 100, Amherst, NY 14221 | 2019-08-01 |
| 1356993976 | Mingzhu Medical Office, P.C. | Clinic/Center | 5615 7th Ave Fl 2, Brooklyn, NY 11220-3509 | 2019-07-13 |
| 1417509357 | Henderson Health Services Family Nurse Practitioner Pllc | Clinic/Center | 4 Clarion Dr, White Plains, NY 10603-2868 | 2019-07-11 |
| 1154988897 | Bissalam Medical LLC | Clinic/Center | 3391 3rd Ave Ste 1, Bronx, NY 10456-5355 | 2019-05-28 |
| 1851859961 | Lower Westchester Medical Associates, P.C. | Clinic/Center | 105 Stevens Ave Ste 305306, Mount Vernon, NY 10550-2686 | 2019-03-07 |
| Find all providers with the same taxonomy | ||||
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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.