Abigail Ruth Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

017834 Issued in NY

Practice address

5010 State Highway 30 Ste 205
Amsterdam, NY 12010

Phone

(518) 842-2663

Fax

(518) 842-4861

NPI assigned

Sep 16, 2014

Last updated

May 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Albany Medical College of Union University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Peter's Health Partners Medical Associates, P.C.Group PAC ID 6103061189, 480 clinicians

St. Mary's HealthcareGroup PAC ID 7618960709, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Peter's Hospital Hospital, Albany, NY, CCN 330057
• St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajohnson3323261@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Marys Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1518926401
  Medicare reassignment Care Compare group NPD
• St. Peter's Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688
  Medicare reassignment NPD
• Ellis Hospital

  • Emergency Medicine Physician
  • Schenectady, NY
  • NPI 1558547034
  Medicare reassignment NPD
• Saratoga Hospital

  • Endocrinology, Diabetes & Metabolism Physician
  • Gansevoort, NY
  • NPI 1033371166
  Medicare reassignment NPD
• Healthcare Partners of Saratoga LTD

  dba Malta Med Emergent Care

  • Urgent Care Clinic/Center
  • Malta, NY
  • NPI 1700159613
  Medicare reassignment
• Albany Medical College

  dba Albany Med EmUrgent Care

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Albany Medical College

  dba Albany Medical College Department of Medicine

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1386689248

  Physician Assistant

  NPD
• Albany Medical College

  dba Albany Medical College Dept of Surgery

  • General Practice Physician
  • Albany, NY
  • NPI 1548290455

  Physician Assistant

  NPD
• Saratoga Hospital

  dba The Community Pharmacy at Saratoga Hospital

  • Community/Retail Pharmacy
  • Saratoga Springs, NY
  • NPI 1164148110
  NPD
• St. Mary's Healthcare

  dba Opioid Treatment Program

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Amsterdam, NY
  • NPI 1700636347
  NPD
• St. Mary's Healthcare

  • Psychiatric Hospital Unit
  • Amsterdam, NY
  • NPI 1164497103
  NPD (past)

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

• St. Mary's Healthcare

  • General Acute Care Hospital
  • Amsterdam, NY
  • NPI 1811977796
  Care Compare affiliation
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1194126607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 STATE HIGHWAY 30 STE 205",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107532",
            "telephone_number": "518-842-2663",
            "fax_number": "518-842-4861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 STATE HIGHWAY 30 STE 205",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "12010",
            "telephone_number": "518-842-2663",
            "fax_number": "518-842-4861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "319 S Manning Blvd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081743",
            "country_code": "US",
            "telephone_number": "518-525-8501",
            "fax_number": "518-525-8503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ABIGAIL",
        "middle_name": "RUTH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "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": "319 S Manning Blvd Ste 206",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abigail Izzo, COTA
• Nagaraj Onkarappa Jajoor, MD
• James M. Charland, MD PC
• Ming Jaw
• Jeremiah Benoit MD, PLLC
• Theresa Marie Johnson, M.S.ED.
• Regina Jon-Nwakalo, NP
• Nicole Lynn Jones, DPT
• K.S.T. Management, LLC (Park Hill Adult Home)
• Barbara Marie Kadyszewski, LCSW

• Physician Assistant in Amsterdam, NY
• Providers in Amsterdam, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.

Verify at the official NPI Registry.