Individual provider Active NPI

Michael Bradley Holmes, MD

  • Cardiovascular Disease Physician
  • Cooperstown, NY
National Provider Identifier
1114935905
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
220419 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1394
Phone
(607) 547-3181
Fax
(607) 547-6857
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 220419 NY
Cardiovascular Disease Physician 207RC0000X 220419 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1394

Mailing address

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3181

Other practice location 1

2546 Balltown Rd
Suite 203
Schenectady, NY 12309-1079
Phone (518) 377-8198 ext. 260

Other practice location 2

99 E State St Ste G05
Gloversville, NY 12078-1203
Phone (518) 773-2303

Other practice location 3

103 Sitterly Rd Ste 2100
Halfmoon, NY 12065-5646
Phone (518) 383-9373

Other practice location 4

3757 Carman Rd Ste 103
Schenectady, NY 12303-5438
Phone (518) 881-0810

Other practice location 5

425 Guy Park Ave Ste 202
Amsterdam, NY 12010-1044
Phone (518) 842-7088

Other practice location 6

23 Arterial Plz # 30-A
Gloversville, NY 12078-2512
Phone (518) 773-2303

Other practice location 7

115 Saratoga Rd Ste 230
Glenville, NY 12302-4226
Phone (518) 348-5300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Payer.Credentialing@sphp.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100406000524 NY Practitioner - Cardiovascular Disease (Cardiology) 7618058082 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Johns Hopkins University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

Hospital & facility affiliations

  • Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136
  • Aurelia Osborn Fox Memorial Hospital Hospital, Oneonta, NY, CCN 330085
  • O'Connor Hospital Hospital, Delhi, NY, CCN 331305
  • Cobleskill Regional Hospital Hospital, Cobleskill, NY, CCN 331320
  • Little Falls Hospital Hospital, Little Falls, NY, CCN 331311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
220419NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Sep 12, 2011 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jun 20, 2022 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jun 20, 2022 Accepting new patients

Locations

2 Palisades Dr
Albany, NY 12205

425 Guy Park Ave
Ste 202
Amsterdam, NY 12010
Phone (518) 842-3330

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

460 Andes Rd
Delhi, NY 13753
Phone (607) 746-0300

23 Arterial Plz
#30A
Gloversville, NY 12078
Phone (518) 773-2303

99 E State St
Ste G5
Gloversville, NY 12078
Phone (518) 773-2303

103 Sitterly Rd
Ste 2100
Halfmoon, NY 12065
Phone (518) 383-9373

140 Burwell St
Little Falls, NY 13365
Phone (315) 823-1000

115 Saratoga Rd
Ste 230
Schenectady, NY 12302
Phone (518) 348-5300

2546 Balltown Rd
Ste 300
Schenectady, NY 12309
Phone (518) 377-8184

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

3757 Carman Rd
Ste 103
Schenectady, NY 12303
Phone (518) 374-7371

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

Interoperability endpoints

  • Direct secure messaging: mholmes357945@bassett.direct-ci.net

Organizations & group practices 7

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 6

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1114935905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-3181",
            "fax_number": "607-547-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261394",
            "telephone_number": "607-547-3181",
            "fax_number": "607-547-6857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2546 Balltown Rd",
            "address_2": "SUITE 203",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123091079",
            "country_code": "US",
            "telephone_number": "518-377-8198 x260",
            "fax_number": "518-377-0620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "99 E State St Ste G05",
            "address_purpose": "LOCATION",
            "city": "Gloversville",
            "state": "NY",
            "postal_code": "120781203",
            "country_code": "US",
            "telephone_number": "518-773-2303",
            "fax_number": "518-773-3670",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Sitterly Rd Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Halfmoon",
            "state": "NY",
            "postal_code": "120655646",
            "country_code": "US",
            "telephone_number": "518-383-9373",
            "fax_number": "518-383-4591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3757 Carman Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123035438",
            "country_code": "US",
            "telephone_number": "518-881-0810",
            "fax_number": "518-881-0811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 Guy Park Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Amsterdam",
            "state": "NY",
            "postal_code": "120101044",
            "country_code": "US",
            "telephone_number": "518-842-7088",
            "fax_number": "518-843-1324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23 Arterial Plz # 30-A",
            "address_purpose": "LOCATION",
            "city": "Gloversville",
            "state": "NY",
            "postal_code": "120782512",
            "country_code": "US",
            "telephone_number": "518-773-2303",
            "fax_number": "518-773-3670",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Saratoga Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Glenville",
            "state": "NY",
            "postal_code": "123024226",
            "country_code": "US",
            "telephone_number": "518-348-5300",
            "fax_number": "518-579-3194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "MICHAEL",
        "middle_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "220419",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "220419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Payer.Credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2546 Balltown Rd",
            "address_2": "SUITE 203",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123091079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.