Individual provider Active NPI

Kristyn Joelle Spencer, PA-C

  • Medical Physician Assistant
  • Gloversville, NY
National Provider Identifier
1144671371
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
019751-1 Issued in NY
Practice address
99 E State St
Gloversville, NY 12078-1203
Phone
(518) 773-5690
NPI assigned
Jun 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 019751-1 NY Primary

Addresses

Primary practice location

99 E State St
Gloversville, NY 12078-1203

Mailing address

99 E State St
Gloversville, NY 12078-1203
Phone (518) 773-5690

Other names 1

  • Kristyn Joelle Cuomo Former name

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
I20160921000948 NY Practitioner - Physician Assistant 4789971623 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

99 E State St
Gloversville, NY 12078-1203
Phone (518) 773-5690

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019751NYMDSpeech-Language Pathologist
019751-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan Littauer Hospital Association CurrentSince Jun 21, 2022 Accepting new patients
Albany Medical College CurrentSince Jul 25, 2016 Accepting new patients
Albany Medical College CurrentSince Jul 25, 2016 Accepting new patients
Nathan Littauer Hospital & Nursing Home CurrentSince Jun 21, 2022 Accepting new patients
Nathan Littauer Hospital Association Past Accepting new patients

Locations

99 E State St
Gloversville, NY 12078
Phone (518) 773-5690

115 Saratoga Rd
Ste 110
Schenectady, NY 12302
Phone (518) 264-2900

11835 Route 9W
West Coxsackie, NY 12192
Phone (518) 731-9000

Organizations & group practices 5

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1144671371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E STATE ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781203",
            "telephone_number": "518-773-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E STATE ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781203",
            "telephone_number": "518-773-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "KRISTYN",
        "middle_name": "JOELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2022-09-12",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "019751-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTYN",
            "last_name": "CUOMO",
            "middle_name": "JOELLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gloversville, NY

Sources for this page

Verify at the official NPI Registry.