Individual provider Active NPI

Elizabeth Anne Locke, MD

  • Family Medicine Physician
  • Latham, NY
National Provider Identifier
1043466709
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2527791 Issued in NY
Practice address
713 Troy Schenectady Rd
Suite 224
Latham, NY 12110-2490
Phone
(518) 785-5881
Fax
(518) 785-3872
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2527791 NY Primary

Addresses

Primary practice location

713 Troy Schenectady Rd
Suite 224
Latham, NY 12110-2490

Mailing address

711 Troy Schenectady Rd
Suite 201
Latham, NY 12110-2442
Phone (518) 782-3700

Other identifiers 2

IdentifierTypeStateIssuer
P00746889OtherNYRR MEDICARE
03130169MedicaidNY

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
I20090806000586 NY Practitioner - Family Practice 5496808545 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2527791NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyview Hospital and Rehabilitation Center CurrentSince Mar 16, 2023 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Family Medicine CurrentSince Mar 16, 2023 Accepting new patients
Ellis Hospital Past Accepting new patients
St. Peter'S Hospital of the City of Albany Family Medicine Past Accepting new patients
St. Peter'S Hospital of the City of Albany Family Medicine Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

713 Troy Schenectady Rd
Ste 224
Latham, NY 12110
Phone (518) 785-3614

711 Troy Schenectady Rd
Ste 201
Latham, NY 12110

1270 Belmont Ave
Schenectady, NY 12308
Phone (518) 382-4500

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: elocke2541424@direct.trinity-health.org

Organizations & group practices 5

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": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1043466709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 TROY SCHENECTADY RD",
            "address_2": "SUITE 224",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102490",
            "telephone_number": "518-785-5881",
            "fax_number": "518-785-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "2527791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00746889",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03130169",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.