NPIMap

Individual provider Active NPI

Ernest M Enzien Jr., MD

  • Family Medicine Physician
  • Rensselaer, NY
National Provider Identifier
1144302886
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
225801 Issued in NY
Practice address
2 Empire Dr Ste 100
Rensselaer, NY 12144-5730
Phone
(518) 475-9518
Fax
(518) 286-4859
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 225801 NY Primary

Addresses

Primary practice location

2 Empire Dr Ste 100
Rensselaer, NY 12144-5730

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other identifiers 1

IdentifierTypeStateIssuer
02337951MedicaidNY

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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406000400 NY Practitioner - Family Practice 7214920289 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2 Empire Dr
Suite 100
Rensselaer, NY 12144-5730
Phone (518) 286-4899

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225801NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health Partners Medical Associates, P.C. Family Medicine CurrentSince Aug 27, 2018 Accepting new patients
Samaritan Hospital of Troy, New York Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Nuvance Health Medical Practice PC Past Accepting new patients

Locations

5 Elm Ave
Delmar, NY 12054
Phone (518) 478-0948

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

713 Troy Schenectady Rd
Ste 224
Latham, NY 12110
Phone (518) 785-3614

2 Empire Dr
Ste 100
Rensselaer, NY 12144
Phone (518) 286-4899

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

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

Interoperability endpoints

  • Direct secure messaging: eenzien150757@direct.trinity-health.org

Organizations & group practices 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1144302886",
    "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": "2 EMPIRE DR STE 100",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121445730",
            "telephone_number": "518-475-9518",
            "fax_number": "518-286-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENZIEN",
        "first_name": "ERNEST",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "225801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02337951",
            "state": "NY"
        }
    ],
    "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": "2 Empire Dr Ste 100",
            "city": "Rensselaer",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121445730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

Verify at the official NPI Registry.