Active NPI
Amy Johnson, PA
- Physician Assistant
- Corinth, NY
National Provider Identifier
1174504385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004694
- Practice address
- 13 Palmer Ave
Evergreen Medical Center
Corinth, NY 12822-1145 - Phone
- (518) 654-6499
- Fax
- (518) 654-7303
- NPI assigned
- Nov 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004694 | NY | Primary |
Addresses
Primary practice location
13 Palmer Ave
Evergreen Medical Center
Corinth, NY 12822-1145
Mailing address
100 Park Stree
Glens Falls Hospital - Credentialing
Glens Falls, NY 12801-4413
Phone (518) 926-5924
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02347657 | Medicaid | NY | |
| P00326248 | Other | NY | RR MEDICARE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Park St
Glens Falls, NY 12801-4413
Phone (518) 926-1000
35 Gilbert St
Cambridge, NY 12816-2618
Phone (518) 677-3961
79 N St
Granville Medical Center
Granville, NY 12832-1137
Phone (518) 642-0612
Hospital & facility affiliations
- Glens Falls Hospital
- Saratoga Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.88 of 100
- Quality
- 71.44
- Promoting interoperability
- 97.95
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glens Falls Hospital Inc | Current | Accepting new patients |
Locations
13 Palmer Ave
Corinth, NY 12822
Phone (518) 654-6499
100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924
79 North St
Granville, NY 12832
Phone (518) 642-0612
Interoperability endpoints
- ajohnson99627@albanymed.direct-ci.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Glens Falls, NY
- NPI 1336198217
-
- Community/Retail Pharmacy
- Glens Falls, NY
- NPI 1619990991
Hospital & facility affiliations 19
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Glens Falls, NY
- NPI 1871606764
-
- Endocrinology, Diabetes & Metabolism Physician
- Gansevoort, NY
- NPI 1033371166
Hospital
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1073569331
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1093078560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1174504385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 PARK STREE",
"address_2": "GLENS FALLS HOSPITAL - CREDENTIALING",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128014413",
"telephone_number": "518-926-5924",
"fax_number": "518-926-6983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 PALMER AVE",
"address_2": "EVERGREEN MEDICAL CENTER",
"city": "CORINTH",
"state": "NY",
"postal_code": "128221145",
"telephone_number": "518-654-6499",
"fax_number": "518-654-7303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "AMY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-07",
"last_updated": "2021-09-01",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004694",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02347657",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00326248",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corinth, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.