Organization Active NPI

St. Peters Health Partners Medical Associates PC

  • Neurology Physician
  • Rensselaer, NY
National Provider Identifier
1154744753
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PC
Practice address
279 Troy Rd
Rensselaer, NY 12144-9518
Phone
(518) 694-3053
Fax
(518) 694-3056
NPI assigned
Feb 3, 2014
Organization subpart
Yes
Parent organization
ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Paul Gordon
Title
Cfo
Phone
(518) 525-1585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

279 Troy Rd
Rensselaer, NY 12144-9518

Mailing address

279 Troy Rd
Rensselaer, NY 12144-9518
Phone (518) 694-3053

National Provider Directory

National Provider Directory
Part of
St Peter'S Health Partners Medical Associates PC

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1154744753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 TROY RD",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121449518",
            "telephone_number": "518-694-3053",
            "fax_number": "518-694-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 TROY RD",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121449518",
            "telephone_number": "518-694-3053",
            "fax_number": "518-694-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. PETERS HEALTH PARTNERS MEDICAL ASSOCIATES PC",
        "enumeration_date": "2014-02-03",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "518-525-1585"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.