Amy J Nistico, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

404277 Issued in NY

Practice address

2215 Burdett Ave
Troy, NY 12180-2475

Phone

(188) 336-4705

Fax

(518) 271-3682

NPI assigned

Aug 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pinnacle Behavioral Health Ipa PLLC

  • Mental Health Counselor
  • Albany, NY
  • NPI 1447276720
  Medicare reassignment NPD
• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  Medicare reassignment NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357
  Medicare reassignment NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106

  Psychiatric/Mental Health

  NPD
• Lee and Burack OB/GYN, P.C.

  • Obstetrics & Gynecology Physician
  • Albany, NY
  • NPI 1801983788
  NPD (past)

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1043948151",
    "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": "2215 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802475",
            "telephone_number": "188-336-4705",
            "fax_number": "518-271-3682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "636 New Loudon Rd",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121104002",
            "country_code": "US",
            "telephone_number": "518-783-5381",
            "fax_number": "518-783-0125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Manning Blvd Ste 6408A",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1303",
            "fax_number": "518-525-5691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2925 Hamburg St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123034349",
            "country_code": "US",
            "telephone_number": "518-357-2909",
            "fax_number": "518-357-2937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 High Rock Ave",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128662307",
            "country_code": "US",
            "telephone_number": "518-885-6884",
            "fax_number": "518-885-0077",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Massachusetts Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801628",
            "country_code": "US",
            "telephone_number": "518-268-5542",
            "fax_number": "518-268-5647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Mercycare Ln",
            "address_purpose": "LOCATION",
            "city": "Guilderland",
            "state": "NY",
            "postal_code": "120843504",
            "country_code": "US",
            "telephone_number": "518-452-6700",
            "fax_number": "518-452-6706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Mohawk St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Cohoes",
            "state": "NY",
            "postal_code": "120472600",
            "country_code": "US",
            "telephone_number": "518-235-1100",
            "fax_number": "518-235-0079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "845 Central Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122061504",
            "country_code": "US",
            "telephone_number": "518-482-2455",
            "fax_number": "518-482-2458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "64 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122021240",
            "country_code": "US",
            "telephone_number": "518-449-5170",
            "fax_number": "518-598-0493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISTICO",
        "first_name": "AMY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404277",
            "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": "2925 Hamburg St Ste 1",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123034349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Troy, NY
• Providers in Troy, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.