Active NPI
Kathy Lynn Herren, PA
- Physician Assistant
- Saratoga Springs, NY
National Provider Identifier
1154312593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004509
- Practice address
- 377 Church St
Saratoga Springs, NY 12866 - Phone
- (518) 584-4456
- NPI assigned
- Nov 3, 2005
- 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 | 004509 | NY | Primary |
Addresses
Primary practice location
377 Church St
Saratoga Springs, NY 12866
Mailing address
PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634
Other practice location 1
135 North Road
Wilton Family Medicine
Wilton, NY 12831
Phone (518) 926-1935
Other practice location 2
27 Hyland Drive
Stuart M Townsend Middle School
Lake Luzerne, NY 12846
Phone (518) 696-2337
Other practice location 3
135 North Road
Wilton Family Medicine
Wilton, NY 12831
Phone (518) 926-1935
Other practice location 4
11 Hampstead Pl N Ste 103
Saratoga Springs, NY 12866-5669
Phone (518) 583-7400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02352454 | Medicaid | NY |
Other names 1
- Kathy Lynn Mazur - Herren
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2 New Hampshire Ave
Troy, NY 12180-1764
Phone (518) 525-8220
4 Congress PL
Saratoga Springs, NY 12866-4180
Phone (518) 450-4594
Hospital & facility affiliations
- Saratoga Hospital
- St Peter'S Hospital
- Glens Falls Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004509 | NY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Peter'S Health Partners Medical Associates, P.C. | Physician Assistant | Current | Accepting new patients |
| St. Peter'S Health Partners Medical Associates, P.C. | Physician Assistant | Past | Accepting new patients |
Locations
4 Congress Pl
Saratoga Springs, NY 12866
Phone (518) 450-4594
11 Hampstead Pl N
Ste 103
Saratoga Springs, NY 12866
Phone (518) 471-3636
377 Church St
Saratoga Springs, NY 12866
Phone (518) 203-2582
2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331
Interoperability endpoints
- kherren84991@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.
-
- Multi-Specialty Clinic/Center
- Albany, NY
- NPI 1750626834
Physician Assistant
-
- Pediatrics Physician
- Slingerlands, NY
- NPI 1669717260
Physician Assistant
Hospital & facility affiliations 20
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Glens Falls, NY
- NPI 1871606764
-
- Endocrinology, Diabetes & Metabolism Physician
- Gansevoort, NY
- NPI 1033371166
Hospital
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1073569331
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1093078560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1154312593",
"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",
"telephone_number": "518-525-5634",
"fax_number": "518-649-4094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "377 CHURCH ST",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "12866",
"telephone_number": "518-584-4456"
}
],
"practiceLocations": [
{
"address_1": "135 North Road",
"address_2": "Wilton Family Medicine",
"address_purpose": "LOCATION",
"city": "Wilton",
"state": "NY",
"postal_code": "12831",
"country_code": "US",
"telephone_number": "518-926-1935",
"fax_number": "518-926-4804",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "27 Hyland Drive",
"address_2": "Stuart M Townsend Middle School",
"address_purpose": "LOCATION",
"city": "Lake Luzerne",
"state": "NY",
"postal_code": "12846",
"country_code": "US",
"telephone_number": "518-696-2337",
"fax_number": "518-696-2160",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "135 North Road",
"address_2": "Wilton Family Medicine",
"address_purpose": "LOCATION",
"city": "Wilton",
"state": "NY",
"postal_code": "12831",
"country_code": "US",
"telephone_number": "518-926-1935",
"fax_number": "518-926-4804",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11 Hampstead Pl N Ste 103",
"address_purpose": "LOCATION",
"city": "Saratoga Springs",
"state": "NY",
"postal_code": "128665669",
"country_code": "US",
"telephone_number": "518-583-7400",
"fax_number": "518-583-4184",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERREN",
"first_name": "KATHY",
"middle_name": "LYNN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-03",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004509",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02352454",
"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": "377 Church St",
"city": "Saratoga Springs",
"state": "NY",
"country_code": "US",
"postal_code": "12866",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KATHY",
"last_name": "MAZUR - HERREN",
"middle_name": "LYNN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Saratoga Springs, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.