Individual provider Active NPI

Kristin Marie Cooke, NP

  • Family Nurse Practitioner
  • Rensselaer, NY
National Provider Identifier
1124021241
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
334209 Issued in NY
Practice address
279 Troy Rd
Rensselaer, NY 12144-9518
Phone
(518) 286-1922
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 340492 NY
Family Nurse Practitioner 363LF0000X 334209 NY Primary

Addresses

Primary practice location

279 Troy Rd
Rensselaer, NY 12144-9518

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

1499 New Scotland Rd
Slingerlands, NY 12159-9209
Phone (518) 320-7517

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101229000796 NY Practitioner - Nurse Practitioner 5799973178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians

Practice addresses (Care Compare)

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3554

279 Troy Rd
Rensselaer, NY 12144-9756
Phone (518) 286-1922

Hospital & facility affiliations

  • Eddy Visiting Nurse & Rehab Association Home health agency, Troy, NY, CCN 337203
  • Community Hospice, Inc, the Hospice, Albany, NY, CCN 331501
  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
334209NYMDFamily Nurse Practitioner
340492NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York CurrentSince Oct 21, 2019 Accepting new patients
Capital Eye Care Physicians and Surgeons, PLLC Past Accepting new patients

Locations

279 Troy Rd
Rensselaer, NY 12144
Phone (518) 286-1922

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: kcooke834501@direct.trinity-health.org

Organizations & group practices 2

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 4

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1124021241",
    "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": "279 TROY RD",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121449518",
            "telephone_number": "518-286-1922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1499 New Scotland Rd",
            "address_purpose": "LOCATION",
            "city": "Slingerlands",
            "state": "NY",
            "postal_code": "121599209",
            "country_code": "US",
            "telephone_number": "518-320-7517",
            "fax_number": "518-439-0214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOKE",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "340492",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "334209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP- Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "279 Troy Rd",
            "city": "Rensselaer",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121449518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

Verify at the official NPI Registry.