NPIMap

Individual provider Active NPI

Ivelisse Ann Verrico, MD

  • Internal Medicine Physician
  • Cohoes, NY
National Provider Identifier
1215973896
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
239266 Issued in NY
Practice address
1019 New Loudon Rd
Cohoes, NY 12047
Phone
(518) 262-7500
Fax
(518) 262-7505
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 239266 NY
Internal Medicine Physician 207R00000X 239266 NY Primary

Addresses

Primary practice location

1019 New Loudon Rd
Cohoes, NY 12047

Mailing address

1019 New Loudon Rd
Cohoes, NY 12047
Phone (518) 262-7500

Other identifiers 1

IdentifierTypeStateIssuer
02737924MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060413000586 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 9133197361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

1019 New Loudon Rd
Cohoes, NY 12047-5003
Phone (518) 262-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239266NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
Albany Medical College Internal Medicine Current Accepting new patients
Albany Medical College Internal Medicine CurrentSince Oct 20, 2016 Accepting new patients
Albany Medical College CurrentSince Oct 20, 2016 Accepting new patients
Albany Medical College Pediatrics Current Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1019 New Loudon Rd
Ste A101
Cohoes, NY 12047

1019 New Loudon Rd
Cohoes, NY 12047
Phone (518) 262-7500

724 Watervliet Shaker Rd
Latham, NY 12110
Phone (518) 262-7500

Interoperability endpoints

  • Direct secure messaging: iverrico34059@albanymed.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1215973896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 NEW LOUDON RD",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "12047",
            "telephone_number": "518-262-7500",
            "fax_number": "518-262-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 NEW LOUDON RD",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "12047",
            "telephone_number": "518-262-7500",
            "fax_number": "518-262-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERRICO",
        "first_name": "IVELISSE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "239266",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "239266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02737924",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cohoes, NY

Sources for this page

Verify at the official NPI Registry.