Individual provider Active NPI

Joseph Tyrone Nista, DDS

  • General Practice Dentistry
  • Albany, NY
National Provider Identifier
1174730527
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
040184 Issued in NY
Practice address
1035 Washington Ave
Albany, NY 12206-1225
Phone
(518) 435-0462
Fax
(518) 435-0487
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 040184 NY Primary

Addresses

Primary practice location

1035 Washington Ave
Albany, NY 12206-1225

Mailing address

14 New Rd
East Greenbush, NY 12061-9605
Phone (518) 479-0993

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160412000432 NY Order and Referring Only - DentistPractitioner - Dentist 7113225905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040184NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph T Nista DDS PLLC General Practice Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174730527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 NEW RD",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120619605",
            "telephone_number": "518-479-0993",
            "fax_number": "518-435-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 WASHINGTON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061225",
            "telephone_number": "518-435-0462",
            "fax_number": "518-435-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISTA",
        "first_name": "JOSEPH",
        "middle_name": "TYRONE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.