Organization Active NPI

St. Peter's Health Partners Medical Associates, P.C.

  • Family Medicine Physician
  • Halfmoon, NY
National Provider Identifier
1083228811
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Practice address
1735 Route 9
St. Peter's Family Medicine
Halfmoon, NY 12065-2411
Phone
(518) 901-1619
NPI assigned
Aug 31, 2020
Last updated
Oct 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Authorized official

Name
Courtney Knowles
Title
Credentialing Manager
Phone
(518) 525-5634

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Registered Nurse 163W00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1735 Route 9
St. Peter's Family Medicine
Halfmoon, NY 12065-2411

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other names 1

  • St. Peter's Family Medicine Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct St. Peter's Health Partners Medical Associates, P.C.

National Provider Directory

National Provider Directory
Tax ID family
Sphpma Crus Urology96 organizations share this tax ID, including this one
Part of
Sphpma Crus Urology

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633478400000",
    "number": "1083228811",
    "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": "1735 ROUTE 9",
            "address_2": "ST. PETER'S FAMILY MEDICINE",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120652411",
            "telephone_number": "518-901-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.",
        "enumeration_date": "2020-08-31",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-525-5634"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "Y",
            "endpointDescription": "SPHP Payer Credentialing",
            "affiliationName": "St. Peter's Health Partners Medical Associates, P.C.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1735 Route 9",
            "address_2": "St. Peter's Family Medicine",
            "city": "Halfmoon",
            "state": "NY",
            "country_code": "US",
            "postal_code": "120652411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St. Peter's Family Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "St. Peter's Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Halfmoon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.