St. Joseph'S Physician Health, P.C.
Organization Active NPI Anesthesiology Physician · Troy, NY
NPI 1154376770 · NPPES record last updated Feb 3, 2023
Key facts
- NPI
- 1154376770
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 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
- Organization subpart
- No
Authorized official
- Name
- William Joseph Kowal, MD
- Title
- President
- Phone
- (518) 525-5634
Practitioners 390
-
Vyachislav Abayev, M.D.
-
Julie N Aliu, CRNA
-
Emily Peebles Alletzhauser, CRNA, BSN, RN, SCRN
-
Andriy Androshchuk, CRNA
-
Anthony A Ascioti, M.D.
-
Dorgam Badran, M.D.
-
Kimberly Bauer, CRNA
-
Whitney Bean Bayly, CRNA
-
Sharon I Bell, CRNA
-
Lindsey Bippus, CRNA
-
Lisa Ann Bristow, CRNA
-
Walter F Bryz-Gornia, M.D.
-
Danielle Cappozzo, CRNA
-
Brian J Chanatry, M.D.
-
Joseph A Corso, MD
-
Genevieve Dalton, MD
-
Michael John Degennaro, CRNA
-
Hailey L Diana, CRNA
-
Christina E Dodge, CRNA
-
George Elbayadi, M.D.
-
Shannon Marie Enders, CRNA
-
Elias Epie, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Locations
8278 Willett Pkwy
#2
Baldwinsville, NY 13027
Phone (315) 652-1325
3452 State Route 31
Baldwinsville, NY 13027
Phone (315) 652-1325
5820 Heritage Landing Dr
East Syracuse, NY 13057
Phone (315) 701-1107
4301 Medical Center Dr
#301
Fayetteville, NY 13066
Phone (315) 634-3399
4104 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7001
4212 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7001
5100 W Taft Rd
Ste 5B
Liverpool, NY 13088
Phone (315) 452-2014
104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Multi-Specialty Clinic/Center | 261QM1300X |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01731713 | Medicaid | NY |
Other names
- Albany THAGNY
- THAGNY
- Trinity Health Anesthesia Group of New York
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | payer.credentialing@sphp.com | Direct | St. Joseph's Physician Health, P.C. |
Other providers in Troy, NY
- Meghan Sponable
- Sporty Spex
- Sarah Eliizabeth Sroka
- St Peters Health Partners Medical Associates, P.C.
- St Peters Health Partners Medical Associates, P.C.
- St. Mary'S Woodland Village
- St. Peter'S Health Partners Medical Assocaites, PC
- St. Peter'S Health Partners Medical Associates, P.C.
- St. Peter'S Health Partners Medical Associates, P.C.
- St. Peter'S Health Partners Medical Associates, P.C.
All providers in Troy, NY · Anesthesiology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.