Individual provider Active NPI

Stephanie J Spear, RPA-C

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1093968323
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005764 Issued in NY
Practice address
400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5013
Phone
(518) 489-0044
Fax
(518) 489-3591
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005764 NY Primary

Addresses

Primary practice location

400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5013

Mailing address

400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5013
Phone (518) 489-0044

Other identifiers 2

IdentifierTypeStateIssuer
03226955MedicaidNY
P01316384OtherNYRAILROAD MEDICARE

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
I20090223000295 NY Practitioner - Physician Assistant 5597820746 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 562-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5764NYMDClinical Psychologist
005764NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Oncology Hematology PC CurrentSince Jul 10, 2013 Accepting new patients
Champlain Valley Physicians Hospital Medical Center Physician Assistant CurrentSince Jan 1, 2022 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Physician Assistant CurrentSince Jan 1, 2013 Accepting new patients

Locations

5 Palisades Dr
Ste 100
Albany, NY 12205
Phone (518) 438-4496

400 Patroon Creek Blvd
Ste 1
Albany, NY 12206
Phone (518) 399-4600

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

2 Empire Dr
Ste 202
Rensselaer, NY 12144
Phone (518) 286-4990

896 Riverview Rd
Rexford, NY 12148
Phone (518) 399-4600

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

2 New Hampshire Ave
Ste 250
Troy, NY 12180
Phone (518) 272-0331

147 Hoosick St
Troy, NY 12180
Phone (518) 268-5749

Interoperability endpoints

  • Direct secure messaging: sspear481525@direct.uvmhealth.org
  • Direct secure messaging: sspear788710@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1093968323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PATROON CREEK BLVD",
            "address_2": "SUITE 1",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122065013",
            "telephone_number": "518-489-0044",
            "fax_number": "518-489-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PATROON CREEK BLVD",
            "address_2": "SUITE 1",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122065013",
            "telephone_number": "518-489-0044",
            "fax_number": "518-489-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEAR",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03226955",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01316384",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.