NPIMap

Organization Active NPI

St. Joseph's Physician Health, P.C.

  • Anesthesiology Physician
  • Troy, NY
National Provider Identifier
1154376770
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ST. JOSEPH'S PHYSICIAN HEALTH, P.C.
Practice address
2215 Burdett Ave
Troy, NY 12180-2466
Phone
(518) 271-3300
NPI assigned
May 23, 2006
Last updated
Feb 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Authorized official

Name
William Joseph Kowal, MDNPI 1669464889
Title
President
Phone
(518) 525-5634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

2215 Burdett Ave
Troy, NY 12180-2466

Mailing address

425 New Scotland Avenue
Payer Credentialing
Albany, NY 12208
Phone (518) 525-5634

Other identifiers 1

IdentifierTypeStateIssuer
01731713MedicaidNY

Other names 3

  • Albany THAGNY Other name
  • THAGNY Other name
  • Trinity Health Anesthesia Group of New York Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct St. Joseph's Physician Health, P.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325001159 NY Part B Supplier - Clinic/Group Practice 9436041431 Receives reassigned benefits from 356 practitioners
Practice locations: Syracuse, NY; Troy, NY; Rome, NY; Fayetteville, NY; East Syracuse, NY

National Provider Directory

National Provider Directory

Locations

425 New Scotland Ave
Albany, NY 12208
Phone (518) 525-6987

3452 State Route 31
Baldwinsville, NY 13027
Phone (315) 652-1325

4000 Medical Center Dr
Ste 208
Fayetteville, NY 13066
Phone (315) 329-7999

4301 Medical Center Dr
#301
Fayetteville, NY 13066
Phone (315) 634-3399

5100 W Taft Rd
Ste 5B
Liverpool, NY 13088
Phone (315) 452-2014

104 Union Ave
Ste 1008
Syracuse, NY 13203
Phone (315) 422-4442

700 E Brighton Ave
Unit 4
Syracuse, NY 13205
Phone (315) 413-3200

Practitioners & affiliated clinicians

Practitioners 390

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 390

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1154376770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 NEW SCOTLAND AVENUE",
            "address_2": "PAYER CREDENTIALING",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802466",
            "telephone_number": "518-271-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S PHYSICIAN HEALTH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "KOWAL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-525-5634",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01731713",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "Y",
            "endpointDescription": "SPHP Payer Credentialing",
            "affiliationName": "St. Joseph's Physician Health, P.C.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2215 Burdett Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121802466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Albany THAGNY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "THAGNY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Trinity Health Anesthesia Group of New York",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.