Active NPI
Sarah L Elmendorf
- Infectious Disease Physician
- Albany, NY
National Provider Identifier
1104919752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 153286
- Practice address
- Upstate Infectious Diseases Associates
404 New Scotland Ave
Albany, NY 12208 - Phone
- (518) 435-0662
- Fax
- (518) 435-0664
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 153286 | NY | Primary |
Addresses
Primary practice location
Upstate Infectious Diseases Associates
404 New Scotland Ave
Albany, NY 12208
Mailing address
Upstate Infectious Diseases Associates
404 New Scotland Ave
Albany, NY 12208
Phone (518) 435-0662
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000402902001 | Other | NY | BLUE SHIELD |
| 925121 | Other | NY | BLUE CROSS |
| 01051183 | Medicaid | NY | |
| 10028381 | Other | NY | CDPHP |
Other names 1
- Miss Sarah L Distefano
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 153286 | NY | MD | Infectious Disease Physician |
Interoperability endpoints
- selmendorf@upstateid.medentdirect.com
- selmendorf24292@albanymed.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1104919752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "UPSTATE INFECTIOUS DISEASES ASSOCIATES",
"address_2": "404 NEW SCOTLAND AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "12208",
"telephone_number": "518-435-0662",
"fax_number": "518-435-0664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UPSTATE INFECTIOUS DISEASES ASSOCIATES",
"address_2": "404 NEW SCOTLAND AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "12208",
"telephone_number": "518-435-0662",
"fax_number": "518-435-0664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELMENDORF",
"first_name": "SARAH",
"middle_name": "L",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "NY",
"license": "153286",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000402902001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "925121",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01051183",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10028381",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SARAH",
"last_name": "DISTEFANO",
"middle_name": "L",
"prefix": "MISS",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.