Mary Anne Jadlos, APRN,BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

430008 Issued in NY

Practice address

2215 Burdett Ave
Troy, NY 12180-2466

Phone

(518) 271-3280

Fax

(518) 271-3462

NPI assigned

Aug 10, 2007

Last updated

May 10, 2021By 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

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

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjadlos783445@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.

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  Medicare reassignment Care Compare group NPD
• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1124502182
  NPD (past)

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1215129564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802466",
            "telephone_number": "518-271-3280",
            "fax_number": "518-271-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802466",
            "telephone_number": "518-271-3280",
            "fax_number": "518-271-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADLOS",
        "first_name": "MARY",
        "middle_name": "ANNE",
        "credential": "APRN,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "430008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Payer.Credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2215 Burdett Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121802466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mizue Iwamoto, MS, ATC, CSCS
• J. Schwartz, MD, PLLC
• Rebecca Jane Jablonski, RN
• Brady Jackson
• Lauren Nicole Jacobs
• Nirmal Kumar Jain, DDS
• Tashona Laurice Jamison
• John S Janikas, MD
• Ania Jankowski, PA-C
• Sarah Janzow

• Acute Care Nurse Practitioner in Troy, NY
• Providers in Troy, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.

Verify at the official NPI Registry.