Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center
Organization Active NPI Ambulatory Surgical Clinic/Center · Niskayana, NY
NPI 1154973071 · NPPES record last updated Jul 11, 2019
Key facts
- NPI
- 1154973071
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- ALBANY MED NISKAYUNA AMBULATORY ENDOSCOPY AND SURGERY CENTER
- Practice address
- 1769 Union Street
3Rd Floor
Niskayana, NY 12309 - Phone
- (518) 688-1880
- Fax
- (518) 881-0003
- NPI assigned
- Jul 11, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- ALBANY MEDICAL CENTER HOSPITAL
Authorized official
- Name
- Ms. Frances S. Albert
- Title
- Evp, Coo, & Cfo
- Phone
- (518) 262-3579
Owners & managing parties with NPI records 3
-
Dennis Patrick McKenna, M.D.
-
Jason Mouzakes, MD
Other NPIs on the same Medicare enrollment 4
Corporate family (same tax ID) 8
Related certifications (CCN) 2
Affiliated clinicians 1,666
-
Christa Rose Abraham, M.D.
-
David Abrahams, M.D.
-
Amanda M Abrams, PA-C
-
Linda M Abriel, NP
-
Michael E Adams, MD
-
Evan Adelstein, MD
-
Rebecca Adler, MD
-
Charles Nyarko Adomfeh, MD, PHD, FACP
-
Farzana Afroze, M.D.
-
Nabras Ahmed, D.O.
-
Shahid Ahmed, MD
-
Salma Akter, M.D.
-
Sailaja Alapati, MD
-
Eyad Aldaas, M.D.
-
William George Alderisio, M.D.
-
Richard Alfred, MD
-
Heather M Ali, PA
-
Darryl Aliggayu, MD
-
Avi Alin, M.D.
Medicare Care Compare: Hospital
- Listed as
- Albany Medical Center Hospital
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Hospital certification: CCN 330013
- Legal name
- ALBANY MEDICAL CENTER HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Apr 18, 2025
- Beds
- 732
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 11, 1849 in NY
- Enrollment address
- 43 New Scotland Ave
Albany, NY 12208-3412 - Hospital subgroups
- Acute care, Other
All disclosed owners & managing parties 37
| Name | Role | Since | Share |
|---|---|---|---|
| Dennis P McKenna |
Corporate Officer |
Apr 1, 2020 | |
| Corporate Director | Apr 1, 2020 | ||
| Lisa J Moser |
Corporate Director |
Jul 1, 2020 | |
| Margaret J Gillis |
Corporate Director |
Jan 14, 2009 | |
| Frances S Albert |
Corporate Officer |
Jul 1, 2016 | |
| Mary C Kahl |
Corporate Director |
May 1, 1984 | |
| Mary G Biebel |
Corporate Director |
Jan 1, 2016 | |
| Morris C Massry |
Corporate Director |
Jul 1, 2015 | |
| John B O'Connor |
Corporate Director |
Jun 1, 2005 | |
| Albany Med Health System |
Operational/Managerial Control | Apr 12, 2021 | 100% |
| Glenda Kelman |
Corporate Director |
Jul 1, 2021 | |
| James J Barba |
Corporate Director |
Oct 8, 1982 | |
| Elizabeth Wood-Pustolka |
Corporate Director | Jul 1, 2023 | |
| Theresa M Skaine |
Corporate Officer | Jan 1, 2019 | |
| Candace K King Weir |
Corporate Director |
Aug 4, 1999 | |
| Shelly a Breton |
W-2 Managing Employee |
Dec 17, 2001 | |
| Sujata N Chaudhry |
Corporate Director |
Jul 1, 2020 | |
| James E Cullum |
Corporate Director |
Jul 1, 2021 | |
| Kirk Kneller |
Corporate Director |
Jul 1, 2022 | |
| Lillian M Moy |
Corporate Director |
Nov 1, 2006 | |
| Jeffrey D Stone |
Corporate Director |
Nov 5, 2008 | |
| Douglas Hamlin |
Corporate Director |
May 7, 2008 | |
| Daniel T. Pickett |
Corporate Director |
Mar 7, 2012 | |
| Sharon M Duker |
Corporate Director |
May 7, 2014 | |
| Frank L Messa |
Corporate Director |
Jul 25, 2025 | |
| Ruth H Mahoney |
Corporate Director |
Jul 1, 2015 | |
| John J Nigro |
Corporate Director |
Feb 6, 2006 | |
| Carolyn J Stefanco |
Corporate Director |
Sep 5, 2018 | |
| Anthony M Durante |
Corporate Director |
Sep 13, 2017 | |
| Raimundo C Archibold |
Corporate Director |
Mar 7, 2012 | |
| Robert T Cushing |
Corporate Director |
Feb 1, 2004 | |
| Carol H Kim |
Corporate Director |
Jul 1, 2020 | |
| Todd M Tidgewell |
Corporate Director |
Mar 3, 2010 | |
| Matthew C Jones |
Corporate Officer | Jul 5, 2017 | |
| David Collins |
Corporate Director |
Jul 25, 2025 | |
| Janice M White |
Corporate Director |
Jan 1, 2017 | |
| Jason Mouzakes |
Corporate Officer | May 1, 2024 | |
| Robert W Diesel |
Corporate Director |
Nov 2, 2005 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080211000539 | NY | Part a Provider - Hospital | 8224018999 |
4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Albany, NY; Niskayuna, NY; Halfmoon, NY; Delmar, NY; Cohoes, NY; Clifton Park, NY |
National Provider Directory
- Tax ID family
- Brent McCarragher
- Part of
- Brent McCarragher
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
1769 Union Street
3Rd Floor
Niskayana, NY 12309
Mailing address
43 New Scotland Avenue
MC-13
Albany, NY 12208-3412
Phone (866) 242-7476
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03000364 | Medicaid | NY |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2019. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.