Individual provider Active NPI

Logan Marie Carpenter, PNP

  • Pediatric Nurse Practitioner
  • Albany, NY
National Provider Identifier
1073302758
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
383711 Issued in NY
Practice address
400 Patroon Creek Blvd Ste 200
Albany, NY 12206-5015
Phone
(518) 525-2445
Fax
(518) 475-7069
NPI assigned
May 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 383711 NY Primary

Addresses

Primary practice location

400 Patroon Creek Blvd Ste 200
Albany, NY 12206-5015

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

326 S Pearl St
Albany, NY 12202-1914
Phone (518) 449-0100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611000293 NY Practitioner - Nurse Practitioner 4587174305 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
383711NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany CurrentSince Jul 14, 2025 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Jul 14, 2025 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. CurrentSince Jul 14, 2025 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Past Accepting new patients
St. Peter'S Hospitalof the City of Albany Past Accepting new patients

Locations

326 S Pearl St
Albany, NY 12202
Phone (518) 449-0100

400 Patroon Creek Blvd
Ste 200
Albany, NY 12206
Phone (518) 442-5463

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

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

Interoperability endpoints

  • Direct secure messaging: lcarpenter4448780@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": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1073302758",
    "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",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PATROON CREEK BLVD STE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122065015",
            "telephone_number": "518-525-2445",
            "fax_number": "518-475-7069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 S Pearl St",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122021914",
            "country_code": "US",
            "telephone_number": "518-449-0100",
            "fax_number": "518-463-8580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "LOGAN",
        "middle_name": "MARIE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383711",
            "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": "400 Patroon Creek Blvd Ste 200",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122065015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.