ELLIS HOSPITAL (NPI# 1760614317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760614317 |
| Entity Type | Organization |
| Organization Name | ELLIS HOSPITAL |
| Practice Address |
1101 Nott St Schenectady NY 12308 |
| Mailing Address |
600 Mcclellan St 2 West Schenectady NY 12304-1009 |
| Practice Telephone | 5182434000 |
| Mailing Telephone | 5183475400 |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2018-08-15 |
| Authorized Official Name | PAUL A MILTON (PRESIDENT & CEO) |
| Authorized Official Telephone | 5182434141 |
| Is Organization Subpart | Y |
| Parent Organization Name | ELLIS HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
4601001H | NY | Behavioral Health & Social Service Providers |
| N | 207R00000X | Internal Medicine | 4601001H | NY | Allopathic & Osteopathic Physicians |
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
4601001H | NY | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
4601001H | NY | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 4601001H | NY | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 4601001H | NY | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03177066 | 05 |
| 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 |
| 1639659931 | Ellis Hospital | Clinic/Center | 103 Sitterly Rd Ste 2300, Halfmoon, NY 12065-5646 | 2018-08-16 |
| 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 |
| Street Address |
1101 NOTT ST |
| City | SCHENECTADY |
| State | NY |
| Zip Code | 12308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245234905 | David M Liebers | Internal Medicine | 1101 Nott St, Schenectady, NY 12308-2425 | 2005-06-10 |
| 1235730722 | Ryker Reilly Bodo | Pharmacist | 1101 Nott St, Schenectady, NY 12308-2425 | 2020-11-03 |
| 1417571290 | Michelle L Rightmyer | Registered Nurse | 1101 Nott St, Schenectady, NY 12308-2425 | 2020-06-08 |
| 1649804204 | Lisa Bzdell | Physical Therapist | 1101 Nott St, Schenectady, NY 12308-2489 | 2020-02-23 |
| 1427696129 | Mary Chew | Physical Therapist | 1101 Nott St, Schenectady, NY 12308-2425 | 2019-12-13 |
| 1962040667 | Alexis Martino | Speech-Language Pathologist | 1101 Nott St, Schenectady, NY 12308-2425 | 2019-12-13 |
| 1598303299 | Kevin Laurilla | Physical Therapist | 1101 Nott St, Schenectady, NY 12308-2425 | 2019-12-13 |
| 1306484001 | Amy Souky | Speech-Language Pathologist | 1101 Nott St, Schenectady, NY 12308-2425 | 2019-12-13 |
| 1851942908 | Emily Proper | Physician Assistant | 1101 Nott St, Schenectady, NY 12308-2489 | 2019-09-20 |
| 1245881382 | Carylann Hedderman Geddes | Physician Assistant | 1101 Nott St, Schenectady, NY 12308-2489 | 2019-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295004125 | Mary C O'brien | Registered Nurse | 90 Elmer Ave, Schenectady, NY 12308 | 2011-12-21 |
| 1114203882 | Gina R Davenport | Speech-Language Pathologist | Zoller Elementary School, 1180 Lancaster Street, Schenectady, NY 12308 | 2011-10-26 |
| 1831472315 | Laura A Denofio | Social Worker | 1445 The Plaza, Schenectady, NY 12308 | 2011-09-21 |
| 1023328440 | Anthony G. Cortese | Social Worker | 1362 Union Street, Schenectady, NY 12308 | 2010-10-19 |
| 1205142288 | Jessica Lee Schoen | Pharmacist | 461 Nott Street, Schenectady, NY 12308 | 2010-08-27 |
| 1932411451 | Tracey E Zusman | Physician Assistant | 1101 Nott St., Schenectady, NC 12308 | 2010-07-13 |
| 1316274194 | Helping Hands Nurse Staffing Services, LLC | Nursing Care | 2180 Avenue B, Schenectady, NY 12308 | 2009-11-16 |
| 1831345628 | Schenectady Radiologists | Radiology | 1101 Nott Street, Schenectady, NY 12308 | 2008-08-12 |
| 1891973459 | Anthony Joseph De Palma Sr. | Dentist | 1351 Union Street, Schenectady, NY 12308 | 2008-02-06 |
| 1447464029 | Lauren Weisberg Savage | Social Worker | 1411 Union Street, Schen, NY 12308 | 2007-05-10 |
| Find all providers in zip 12308 | ||||
| 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 |
|---|---|---|---|---|
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1356784839 | Nicole Tetreault | Family Medicine | 3757 Carman Rd Ste 100, Schenectady, NY 12303-5438 | 2013-04-15 |
| 1780919266 | John E Hargraves | Family Medicine | 3681 E Lydius St, Schenectady, NY 12303-3562 | 2009-10-16 |
| 1639205636 | Paul J Byron | Family Medicine | 500 Balltown Rd, Schenectady, NY 12304-2247 | 2007-02-26 |
| 1790830222 | Union Street Family Medicine, LLC | Family Medicine | 1325 Union St, Schenectady, NY 12308-3033 | 2007-01-24 |
| 1285724294 | Shahida Parveen Mirza | Family Medicine | 2125 River Rd Ste 202, Schenectady, NY 12309-1135 | 2006-10-13 |
| 1225051253 | Zofia Wanda Drzymalski | Family Medicine | 1667 Elizabeth St, Schenectady, NY 12303-3805 | 2006-07-25 |
| 1770518722 | Siren Rasik Chudgar | Family Medicine | 976 Balltown Rd, Schenectady, NY 12309-6428 | 2006-07-11 |
| 1518932458 | Juanito Antonio Reyes | Family Medicine | 624 Mcclellan St Ste 101, Schenectady, NY 12304-1020 | 2006-02-22 |
| 1174598387 | Donna Tuttle | Family Medicine | 3040 Broadway, Schenectady, NY 12306-2102 | 2006-02-21 |
| Find all providers in SCHENECTADY | ||||
| City | SCHENECTADY |
| Zip Code | 12308 |
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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.