Individual provider Active NPI

Magdeline Inzerilli, RPA-C

  • Physician Assistant
  • Glens Falls, NY
National Provider Identifier
1114960580
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008838 Issued in NY
Practice address
100 Broad St
Glens Falls, NY 12801-4349
Phone
(518) 792-2223
Fax
(518) 792-8231
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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 008838 NY Primary

Addresses

Primary practice location

100 Broad St
Glens Falls, NY 12801-4349

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other practice location 1

3767 Main St
Warrensburg, NY 12885-1890
Phone (518) 623-2844

Other identifiers 1

IdentifierTypeStateIssuer
02803592MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address magdeline.inzerilli.1@1823.direct.athenahealth.com
Direct Messaging Address magdeline.inzerilli.1@1823.direct.athenahealth.com

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
I20040612000120 NY Practitioner - Physician Assistant 1052394657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1708 Altamount Ave
Schenectady, NY 12303-2137
Phone (518) 344-4778

202 Broad St
Glens Falls, NY 12801-4146
Phone (518) 480-6240

204 S Broadway
Saratoga Springs, NY 12866-4570
Phone (518) 226-3288

233 Saratoga Rd
Glenville, NY 12302-4508
Phone (518) 930-7497

446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008838NYMDClinical Psychologist

Interoperability endpoints

  • Direct secure messaging: magdeline.inzerilli.1@1823.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1114960580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300",
            "fax_number": "518-824-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROAD ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014349",
            "telephone_number": "518-792-2223",
            "fax_number": "518-792-8231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3767 Main St",
            "address_purpose": "LOCATION",
            "city": "Warrensburg",
            "state": "NY",
            "postal_code": "128851890",
            "country_code": "US",
            "telephone_number": "518-623-2844",
            "fax_number": "518-623-3416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INZERILLI",
        "first_name": "MAGDELINE",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02803592",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "magdeline.inzerilli.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "100 Broad St",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128014349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "magdeline.inzerilli.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3767 Main St",
            "city": "Warrensburg",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128851890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.