Active NPI
Kelly Irwin Pagnotti, FNP
- Family Nurse Practitioner
- Albany, NY
National Provider Identifier
1013359629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F338135-1
- Practice address
- 315 S Manning Blvd
Albany, NY 12208 - Phone
- (518) 525-1550
- NPI assigned
- Jul 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F338135-1 | NY | Primary |
Addresses
Primary practice location
315 S Manning Blvd
Albany, NY 12208
Mailing address
PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140204001011 | NY | Practitioner - Nurse Practitioner | 3173752615 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F338135-1 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Peter'S Hospital of the City of Albany | Current | Accepting new patients |
Locations
315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852
Interoperability endpoints
- kpagnotti789374@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": "1374624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622505600000",
"number": "1013359629",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 S MANNING BLVD",
"city": "ALBANY",
"state": "NY",
"postal_code": "12208",
"telephone_number": "518-525-1550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGNOTTI",
"first_name": "KELLY",
"middle_name": "IRWIN",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-24",
"last_updated": "2021-06-01",
"certification_date": "2021-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F338135-1",
"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": "315 S Manning Blvd",
"city": "Albany",
"state": "NY",
"country_code": "US",
"postal_code": "12208",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Albany, NY
Sources for this page
- 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.