Active NPI
Magdeline Inzerilli, RPA-C
- Physician Assistant
- Glens Falls, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 008838
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02803592 | Medicaid | NY |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 008838 | NY | MD | Clinical Psychologist |
Interoperability endpoints
- 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.
-
- Urgent Care Clinic/Center
- Liverpool, NY
- NPI 1669825162
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.