Individual provider Active NPI

Garry Durosier, MD

  • Pediatrics Physician
  • Troy, NY
National Provider Identifier
1003128109
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
272816 Issued in NY
Practice address
1300 Massachusetts Ave
Troy, NY 12180-1628
Phone
(518) 272-7614
Fax
(518) 272-4365
NPI assigned
Jul 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X T-02774 KS
Pediatrics Physician 208000000X 272816 NY Primary

Addresses

Primary practice location

1300 Massachusetts Ave
Troy, NY 12180-1628

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

2215 Burdett Ave Fl 2
Troy, NY 12180-2466
Phone (518) 272-7614

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170524000262 NY Practitioner - Pediatric Medicine 1052509726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T-02774KSMDPediatrics Physician
272816NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York CurrentSince Jan 1, 2019 Accepting new patients

Locations

713 Troy Schenectady Rd
Ste 304
Latham, NY 12110
Phone (518) 373-4448

500 Federal St
Ste 602
Troy, NY 12180
Phone (518) 272-7614

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

2215 Burdett Ave
Fl 2
Troy, NY 12180
Phone (518) 270-3008

Interoperability endpoints

  • Direct secure messaging: gdurosier834523@direct.trinity-health.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1003128109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MASSACHUSETTS AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121801628",
            "telephone_number": "518-272-7614",
            "fax_number": "518-272-4365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-272-7614",
            "fax_number": "518-272-4365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUROSIER",
        "first_name": "GARRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "T-02774",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "272816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1300 Massachusetts Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121801628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.