Individual provider Active NPI

Samuel F Bosco, MD

  • Emergency Medicine Physician
  • Albany, NY
National Provider Identifier
1194752402
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
170462-1 Issued in NY
Practice address
315 S Manning Blvd
@ St. Peters Hospital ER Dept.
Albany, NY 12208-1707
Phone
(518) 525-1324
Fax
(518) 383-4223
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 170462-1 NY Primary

Addresses

Primary practice location

315 S Manning Blvd
@ St. Peters Hospital ER Dept.
Albany, NY 12208-1707

Mailing address

PO Box 809
Livingston, NJ 07039-0809
Phone (800) 345-0064

Other identifiers 1

IdentifierTypeStateIssuer
01831121MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170462-1NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Emergency Medicine Associates, PC Emergency Medicine PastSince Jun 26, 2002 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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1194752402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070390809",
            "telephone_number": "800-345-0064",
            "fax_number": "973-251-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "address_2": "@ ST. PETERS HOSPITAL ER DEPT.",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1324",
            "fax_number": "518-383-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCO",
        "first_name": "SAMUEL",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "170462-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01831121",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.