Individual provider Active NPI

Maria Gebremichael, FNP-C

  • Family Nurse Practitioner
  • Glens Falls, NY
National Provider Identifier
1215597471
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344565 Issued in NY
Practice address
1 Lawrence St
Glens Falls, NY 12801-3617
Phone
(518) 798-9985
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344565 NY Primary

Addresses

Primary practice location

1 Lawrence St
Glens Falls, NY 12801-3617

Mailing address

532 Moe Rd
Clifton Park, NY 12065-3822
Phone (518) 383-2425

Other practice location 1

532 Moe Rd
Clifton Park, NY 12065-3822
Phone (518) 383-2425

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611002639 NY Practitioner - Nurse Practitioner 3173033883 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
344565NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Children'S Health Physicians, LLP CurrentSince Jul 1, 2025 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Jul 1, 2025 Accepting new patients
Four Seasons Pediatrics, LLC Past Accepting new patients

Locations

532 Moe Rd
Clifton Park, NY 12065
Phone (518) 243-3322

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

400 Columbus Ave
Ste 200E
Valhalla, NY 10595
Phone (314) 400-4416

Interoperability endpoints

  • Direct secure messaging: maria.gebremichael.p1@direct.cwpw.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1215597471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 MOE RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653822",
            "telephone_number": "518-383-2425",
            "fax_number": "518-383-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAWRENCE ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013617",
            "telephone_number": "518-798-9985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "532 Moe Rd",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120653822",
            "country_code": "US",
            "telephone_number": "518-383-2425",
            "fax_number": "518-383-3255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEBREMICHAEL",
        "first_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.