Individual provider Active NPI

Laura Ellen Staff, MD

  • Family Medicine Physician
  • Albany, NY
National Provider Identifier
1174521363
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
198187 Issued in NY
Practice address
3 Wembley CT
Ste 101
Albany, NY 12205-3891
Phone
(518) 869-4300
Fax
(518) 869-8386
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 198187 NY Primary

Addresses

Primary practice location

3 Wembley CT
Ste 101
Albany, NY 12205-3891

Mailing address

22 Ridgefield St
Albany, NY 12208-2908

Other identifiers 1

IdentifierTypeStateIssuer
01628082MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090121000011 NY Practitioner - Family Practice 3870656754 Practice locations: Albany, NY

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albany Medical College of Union University, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3 Wembley CT
Suite 101
Albany, NY 12205-3891
Phone (518) 869-4300

Hospital & facility affiliations

  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Capital District Medical & Wellness PC Family Medicine Current Accepting new patients

Locations

3 Wembley Ct
Ste 101
Albany, NY 12205
Phone (518) 869-4300

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506470400000",
    "number": "1174521363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 RIDGEFIELD ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WEMBLEY CT",
            "address_2": "STE 101",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122053891",
            "telephone_number": "518-869-4300",
            "fax_number": "518-869-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFF",
        "first_name": "LAURA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2017-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "198187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01628082",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.