Individual provider Active NPI

Isha N Vyas, PA

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1144742875
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00531500 Issued in NY
Practice address
315 So Manning Blvd
St. Peter'S Hospital of the City of Albany
Albany, NY 12208
Phone
(518) 525-1550
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00531500 NJ
Physician Assistant 363A00000X 25MP00531500 NY Primary

Addresses

Primary practice location

315 So Manning Blvd
St. Peter'S Hospital of the City of Albany
Albany, NY 12208

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

110 Rehill Ave
Somerville, NJ 08876-2519
Phone (908) 685-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20200331000897 NJ Practitioner - Physician Assistant 6709158611 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020885NYMDOccupational Therapist
25MP00531500NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Jan 1, 2024 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Jan 1, 2024 Accepting new patients
Saint Peter'S University Hospital CurrentSince Mar 2, 2020 Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince May 16, 2022 Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince May 16, 2022 Accepting new patients

Locations

401 Ridge Rd
Ste 6
Dayton, NJ 08810
Phone (732) 329-4800

254 Easton Ave
Ofc
New Brunswick, NJ 08901
Phone (732) 745-6674

254 Easton Ave
#4
New Brunswick, NJ 08901

123 How Ln
New Brunswick, NJ 08901
Phone (732) 448-1000

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

5 Plainsboro Rd
Ste 260
Plainsboro, NJ 08536
Phone (609) 372-3220

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

Interoperability endpoints

  • Direct secure messaging: isha.vyas.1@8568.direct.athenahealth.com

Organizations & group practices 8

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1144742875",
    "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": "315 SO MANNING BLVD",
            "address_2": "ST. PETER'S HOSPITAL OF THE CITY OF ALBANY",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-525-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Rehill Ave",
            "address_purpose": "LOCATION",
            "city": "Somerville",
            "state": "NJ",
            "postal_code": "088762519",
            "country_code": "US",
            "telephone_number": "908-685-2200",
            "fax_number": "732-923-2272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VYAS",
        "first_name": "ISHA",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00531500",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "25MP00531500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.