Individual provider Active NPI

Ataul Ghani, PA

  • Physician Assistant
  • Rensselaer, NY
National Provider Identifier
1154867620
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020438 Issued in NY
Practice address
53 Columbia Street
St. Peter's Hospital Rensselaer Health Center
Rensselaer, NY 12144-2933
Phone
(518) 434-2526
Fax
(518) 434-2595
NPI assigned
Jan 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020438 NY Primary

Addresses

Primary practice location

53 Columbia Street
St. Peter's Hospital Rensselaer Health Center
Rensselaer, NY 12144-2933

Mailing address

PO Box 14890
St. Peter's Health Partners Payer Credentialing
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

326 S Pearl St
Albany, NY 12202-1914
Phone (518) 449-0100

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170203000641 NY Practitioner - Physician Assistant 9638452360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellnow Urgent Care, P.C.Group PAC ID 8325320864, 395 clinicians

Practice addresses (Care Compare)

1438 Western Ave
Albany, NY 12203-3421
Phone (518) 649-9986

573 N Greenbush Rd
Rensselaer, NY 12144-9451
Phone (518) 268-2345

7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Hospital of the City of Albany Physician Assistant CurrentSince Mar 20, 2017 Accepting new patients
St. Peter's Hospital of the City of Albany Physician Assistant CurrentSince Mar 20, 2017 Accepting new patients
St. Peter's Hospitalof the City of Albany Physician Assistant Past Accepting new patients

Locations

326 S Pearl St
Albany, NY 12202
Phone (518) 449-0100

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

53 Columbia St
Rensselaer, NY 12144
Phone (518) 434-2526

Interoperability endpoints

  • Direct secure messaging: aghani789283@direct.trinity-health.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1154867620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "address_2": "ST. PETER'S HEALTH PARTNERS PAYER CREDENTIALING",
            "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": "53 COLUMBIA STREET",
            "address_2": "ST. PETER'S HOSPITAL RENSSELAER HEALTH CENTER",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121442933",
            "telephone_number": "518-434-2526",
            "fax_number": "518-434-2595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 S Pearl St",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122021914",
            "country_code": "US",
            "telephone_number": "518-449-0100",
            "fax_number": "518-463-8580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHANI",
        "first_name": "ATAUL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-09",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020438",
            "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": "53 Columbia Street",
            "address_2": "St. Peter's Hospital Rensselaer Health Center",
            "city": "Rensselaer",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121442933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

Verify at the official NPI Registry.