Active NPI
Amy L Hettrich, P.A.
- Adult Health Clinical Nurse Specialist
- Burnt Hills, NY
National Provider Identifier
1063599652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Clinical Nurse Specialist
- License
- 005898
- Practice address
- 848 Route 50
Burnt Hills, NY 12027 - Phone
- (518) 831-1500
- Fax
- (518) 377-1677
- NPI assigned
- Nov 1, 2006
- Last updated
- Mar 16, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005898 | NY | |
| Adult Health Clinical Nurse Specialist | 364SA2200X | 005898 | NY | Primary |
Addresses
Primary practice location
848 Route 50
Burnt Hills, NY 12027
Mailing address
PO Box 569
848 Route 50
Burnt Hills, NY 12027-0569
Phone (518) 831-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02554974 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5898 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saratoga Emergency Physicians, PC | Past | Accepting new patients | |
| Capital Region Primary Care PLLC | Past | Accepting new patients | |
| Saratoga Hospital | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Malta, NY
- NPI 1164864641
-
- Hospitalist Physician
- Saratoga Springs, NY
- NPI 1164464749
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489622400000",
"number": "1063599652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 569",
"address_2": "848 ROUTE 50",
"city": "BURNT HILLS",
"state": "NY",
"postal_code": "120270569",
"telephone_number": "518-831-1500",
"fax_number": "518-377-1677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "848 ROUTE 50",
"city": "BURNT HILLS",
"state": "NY",
"postal_code": "12027",
"telephone_number": "518-831-1500",
"fax_number": "518-377-1677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETTRICH",
"first_name": "AMY",
"middle_name": "L",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2017-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "005898",
"primary": false
},
{
"code": "364SA2200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Adult Health",
"state": "NY",
"license": "005898",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02554974",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burnt Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.