Mary Annelle Collins, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016663 Issued in NY

Practice address

2 New Hampshire Ave
Troy, NY 12180-1764

Phone

(518) 272-0331

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Cherokee Emergency Services, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
  • NPI 1992754717
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1154537264",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 NEW HAMPSHIRE AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121801764",
            "telephone_number": "518-272-0331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Palisades Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122056433",
            "country_code": "US",
            "telephone_number": "518-438-4496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301142408",
            "country_code": "US",
            "telephone_number": "770-720-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MARY",
        "middle_name": "ANNELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005018",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016663",
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "5 Palisades Dr Ste 100",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122056433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Faye Coleman
• David Carl Coletti, MD
• Judith Walker Coletti, MSN
• Collar City Podiatry PLLC
• John A Collins, M.D.
• Nora Collins
• Pamela Colozza
• Christine Marie Colucci, LMHC
• Laney Rae Comitale, PA-C
• Commission on Economic Opportunity for the Greater Capital Region, Inc

• Physician Assistant in Troy, NY
• Providers in Troy, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.