Sandra Mackinnon Perdek, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

333880 Issued in NY

Practice address

1101 Nott St
Schenectady, NY 12308-2425

Phone

(518) 243-4000

NPI assigned

Jul 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

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

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ellis HospitalGroup PAC ID 5890607410, 250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ellis Hospital Hospital, Schenectady, NY, CCN 330153

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.

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Medicare reassignment Care Compare group NPD
• Ellis Hospital

  • Family Medicine Physician
  • Schenectady, NY
  • NPI 1760614317
  NPD (past)

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

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Care Compare affiliation

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1083648315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MCCLELLAN ST",
            "address_2": "2 W - MSO",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NOTT ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082425",
            "telephone_number": "518-243-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDEK",
        "first_name": "SANDRA",
        "middle_name": "MACKINNON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "302354",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI-HMO",
            "identifier": "000000092603",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS CARE",
            "identifier": "050806000037",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "788114",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000490314003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI-PPO",
            "identifier": "7599225",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Estelle Marie Peek, RN
• Lorraine Elizabeth Peek, REGISTERED NURSE
• Tara Marie Peek, RN
• Bettina Andrea Pels-Wetzel, DDS
• James E Penk, LCSW-R
• Steven W Perdek, LMHC-D
• Todd Pereira, OD
• Brittany Catherine Perez, FNP-BC
• Mandy Lynn Perez, LPN
• Sara Perkins

• Family Nurse Practitioner in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.