Shane Evander Martin

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Practice address

11835 RT 9W
West Coxsackie, NY 12192-3605

Phone

(518) 264-9000

NPI assigned

Jun 6, 2022

Last updated

Mar 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

Merit-based Incentive Payment System (MIPS)

Final score

87.78 of 100Reported as group

Quality

77.53

Promoting interoperability

100

Improvement activities

40

Cost

76.35

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Albany Medical College

  dba Albany Med Emurgentcare

  • Urgent Care Clinic/Center
  • West Coxsackie, NY
  • NPI 1366872244
  Medicare reassignment Care Compare group NPD
• Albany Medical College

  dba Albany Medical College Dept of Emergency Medicine

  • Emergency Medicine Physician
  • Albany, NY
  • NPI 1174553093
  NPD
• Albany Medical College

  dba Albany Med EmUrgent Care

  • Urgent Care Clinic/Center
  • Mechanicville, NY
  • NPI 1346791324
  NPD
• Albany Medical College

  dba Albany Med EmUrgent Care

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Albany Medical College

  dba Albany Medical College Department of Medicine

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1386689248
  NPD
• Albany Medical College

  dba Albany Medical College Department of Pediatrics

  • Pediatrics Physician
  • Albany, NY
  • NPI 1750315636
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Niskayana, NY
  • NPI 1154973071

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1376577247
  Care Compare affiliation
• Albany Medical Center Hospital

  • Clinical Medical Laboratory
  • Albany, NY
  • NPI 1700204641

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • Radiology Clinic/Center
  • Albany, NY
  • NPI 1811448657

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  dba Albany Medical Center South Clinical Campus

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1811917461
  Care Compare affiliation

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1043949175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 RT 9W",
            "city": "WEST COXSACKIE",
            "state": "NY",
            "postal_code": "121923605",
            "telephone_number": "518-264-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 RT 9W",
            "city": "WEST COXSACKIE",
            "state": "NY",
            "postal_code": "121923605",
            "telephone_number": "518-264-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHANE",
        "middle_name": "EVANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Knapp
• Carol Ann Levett, PH.D.
• Dawn L Lindberg, RPA-C
• Paige Francine Lorette, LMHC
• Hayley Madsen, DPT
• Marvin a. Gertzberg, D.D.S.
• Colleen McNally, PT
• Nicole Elizabeth Mokszycki, PA-C
• New Baltimore Family Dentistry, LLP
• Robert Ordish, PA-C

• Urgent Care Clinic/Center in West Coxsackie, NY
• Providers in West Coxsackie, NY by specialty
• Urgent Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.
• 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.