NPIMap

Organization Active NPI

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

  • Surgery Physician
  • Troy, NY
National Provider Identifier
1104356070
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Practice address
720 Hoosick Rd
Troy, NY 12180-6673
Phone
(518) 687-9779
NPI assigned
Jun 14, 2017
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 Sep 1, 2026

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

Authorized official

Name
Gary Terk
Title
Credentialing Manager
Phone
(518) 525-5634

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Multi-Specialty Clinic/Center 261QM1300X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

720 Hoosick Rd
Troy, NY 12180-6673

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

624 McClellan St Ste G01
Schenectady, NY 12304-1024
Phone (518) 687-9779

Other practice location 2

4 Congress Pl
Saratoga Springs, NY 12866-4180
Phone (518) 687-9779

Other identifiers 1

IdentifierTypeStateIssuer
03539695MedicaidNY

Other names 1

  • St. Peter's Bariatric and Metabolic Care Other name

Electronic endpoints 1

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

National Provider Directory

National Provider Directory
Tax ID family
St Peter'S Health Partners Medical Associates PC95 organizations share this tax ID, including this one
Part of
St Peter'S Health Partners Medical Associates PC

Organizations with this tax ID in the same state 20

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

View all 20

Locations

1444 Western Ave
Ste D
Albany, NY 12203
Phone (518) 452-0287

377 Church St
Saratoga Springs, NY 12866
Phone (518) 203-2582

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1104356070",
    "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": "720 HOOSICK RD",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121806673",
            "telephone_number": "518-687-9779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 McClellan St Ste G01",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123041024",
            "country_code": "US",
            "telephone_number": "518-687-9779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Congress Pl",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128664180",
            "country_code": "US",
            "telephone_number": "518-687-9779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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": "2017-06-14",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "TERK",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-525-5634"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03539695",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.crednetialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "720 Hoosick Rd",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121806673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St. Peter's Bariatric and Metabolic Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.