Individual provider Active NPI

Amy Beth Paddock, FNP

  • Family Nurse Practitioner
  • Gloversville, NY
National Provider Identifier
1104276203
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
340684-1 Issued in NY
Practice address
182 Steele Ave
Gloversville, NY 12078-4617
Phone
(518) 725-8656
Fax
(518) 775-4192
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 340684-1 NY Primary

Addresses

Primary practice location

182 Steele Ave
Gloversville, NY 12078-4617

Mailing address

99 East State Street
PO Box250
Gloversville, NY 12078-1203
Phone (518) 725-8656

Other practice location 1

242 E State St Ext
Gloversville, NY 12078-6039
Phone (518) 725-8656

Other names 1

  • Amy Beth Hall Former name

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
I20160913002071 NY Practitioner - Nurse Practitioner 9234459116 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

99 E State St
Gloversville, NY 12078-1203
Phone (518) 773-5690

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
340684-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley H Paddock MD Current Accepting new patients
Nathan Littauer Hospital Association CurrentSince May 1, 2019 Accepting new patients
Nathan Littauer Hospital Association Current Accepting new patients
Gloversville Physician Medicine Services PC CurrentSince Jun 12, 2022 Accepting new patients
Nathan Littauer Hospital & Nursing Home CurrentSince May 1, 2019 Accepting new patients

Locations

182 Steele Ave
Gloversville, NY 12078
Phone (518) 725-2620

99 E State St
Gloversville, NY 12078
Phone (518) 773-5690

Interoperability endpoints

  • Direct secure messaging: apaddock.nlh@hixny.net

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.

Hospital & facility affiliations 4

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1104276203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EAST STATE STREET",
            "address_2": "PO BOX250",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781203",
            "telephone_number": "518-725-8656",
            "fax_number": "518-775-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 STEELE AVE",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120784617",
            "telephone_number": "518-725-8656",
            "fax_number": "518-775-4192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 E State St Ext",
            "address_purpose": "LOCATION",
            "city": "Gloversville",
            "state": "NY",
            "postal_code": "120786039",
            "country_code": "US",
            "telephone_number": "518-725-8656",
            "fax_number": "518-773-7824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADDOCK",
        "first_name": "AMY",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340684-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "HALL",
            "middle_name": "BETH",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gloversville, NY

Sources for this page

Verify at the official NPI Registry.