Tamara Jennifer Wrzesinski, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

260478 Issued in NY

Practice address

1092 Madison Ave
Albany, NY 12208-2248

Phone

(518) 525-2445

NPI assigned

Oct 11, 2005

Last updated

Jun 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Tamara J Green Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twrzesinski789192@direct.trinity-health.org

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

• St. Peter's Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834

  Pediatrics

  Medicare reassignment NPD
• St. Peter's Hospital of the City of Albany

  dba St. Peter's Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357

  Pediatrics

  Medicare reassignment NPD
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  NPD
• St. Peter's Health Partners Medical Associates, P.C.

  • Pediatrics Physician
  • Slingerlands, NY
  • NPI 1669717260
  NPD (past)
• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1003804360",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 MADISON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082248",
            "telephone_number": "518-525-2445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 New Scotland Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Slingerlands",
            "state": "NY",
            "postal_code": "121599222",
            "country_code": "US",
            "telephone_number": "518-478-9423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "326 S Pearl St",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122021914",
            "country_code": "US",
            "telephone_number": "518-449-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRZESINSKI",
        "first_name": "TAMARA",
        "middle_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "043303",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "260478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001433036",
            "state": "CT"
        }
    ],
    "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": "1092 Madison Ave",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122082248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "GREEN",
            "middle_name": "J",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Anne Woythal, RD
• Brianna Wright, LMSW
• Quiseana J Wright
• Robert Wright, LMSW
• Stephen Henry Wrzesinski, M.D., PHD
• An-Ya S Wu
• Gregory Wu, MD
• Lyman Wu, DO
• Nini Wu, M.D.
• Regina Wu, MSW, LMSW

• Pediatrics Physician in Albany, NY
• Providers in Albany, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.