NPIMap

Organization Active NPI

Albany Urology Clinic

  • Urology Physician
  • Albany, GA
National Provider Identifier
1043383623
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ALBANY UROLOGY CLINIC
Practice address
2400 Osler CT
Albany, GA 31707-0205
Phone
(229) 883-1503
NPI assigned
Nov 15, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Michael Dukes
Title
Administrator
Phone
(229) 883-1503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

2400 Osler CT
Albany, GA 31707-0205

Mailing address

2400 Osler CT
Albany, GA 31707-0205
Phone (229) 883-1503

Other identifiers 1

IdentifierTypeStateIssuer
00016673AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000606 GA Part B Supplier - Clinic/Group Practice 2365423647 Receives reassigned benefits from 11 practitioners
Practice locations: Albany, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0265772Albany Urology Clinic PC2400 Osler Court, Albany, GA 31707RegistrationJun 21, 2028

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

52 Commercial Way
Spring Hill, FL 34606

Interoperability endpoints

  • Direct secure messaging: ashleygavelek@aucsc.allscriptsdirect.net
  • Direct secure messaging: kathleencooper@aucsc.allscriptsdirect.net
  • Direct secure messaging: khaledajib@aucsc.allscriptsdirect.net
  • Direct secure messaging: maryhockman@aucsc.allscriptsdirect.net
  • Direct secure messaging: michaelmonahan@aucsc.allscriptsdirect.net
  • Direct secure messaging: rodneysiau@aucsc.allscriptsdirect.net
  • Direct secure messaging: stevensnipes@aucsc.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1043383623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 OSLER CT",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317070205",
            "telephone_number": "229-883-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 OSLER CT",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317070205",
            "telephone_number": "229-883-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBANY UROLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DUKES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "229-883-1503",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00016673A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.