Individual provider Active NPI

Charles A Trout, M.D.

  • Internal Medicine Physician
  • Albany, NY
National Provider Identifier
1215929344
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
147030 Issued in NY
Practice address
1444 Western Avenue
Suite B-2
Albany, NY 12203-3458
Phone
(518) 458-8014
Fax
(518) 533-6714
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 147030 NY
Internal Medicine Physician 207R00000X 147030 NY Primary

Addresses

Primary practice location

1444 Western Avenue
Suite B-2
Albany, NY 12203-3458

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other identifiers 1

IdentifierTypeStateIssuer
01160012MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901001439 NY Practitioner - Family Practice 2264407105 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health Partners Medical Associates, P.C. Internal Medicine CurrentSince Jan 1, 2013 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Paul E Lemanski MD PLLC Internal Medicine Past Accepting new patients

Locations

1444 Western Ave
Ste B2
Albany, NY 12203
Phone (518) 458-2611

2 Palisades Dr
Ste 200
Albany, NY 12205

29 Jones Ave
Chatham, NY 12037
Phone (518) 392-1122

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

1301 River St
Ste 204
Valatie, NY 12184
Phone (518) 392-8600

Interoperability endpoints

  • Direct secure messaging: ctrout789181@direct.trinity-health.org

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1215929344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 WESTERN AVENUE",
            "address_2": "SUITE B-2",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033458",
            "telephone_number": "518-458-8014",
            "fax_number": "518-533-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUT",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "147030",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "147030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01160012",
            "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": "1444 Western Avenue",
            "address_2": "Suite B-2",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122033458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.