Individual provider Active NPI

Wade Rodenmayer, PA

  • Physician Assistant
  • Saratoga Springs, NY
National Provider Identifier
1225227762
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012187 Issued in NY
Practice address
409 Maple Ave
Saratoga Springs, NY 12866-5502
Phone
(518) 584-1656
Fax
(518) 584-1822
NPI assigned
Oct 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 012187 NY Primary

Addresses

Primary practice location

409 Maple Ave
Saratoga Springs, NY 12866-5502

Mailing address

409 Maple Ave
Saratoga Springs, NY 12866-5502
Phone (518) 584-1656

Other identifiers 1

IdentifierTypeStateIssuer
P00621563OtherNYRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071220000453 NY Practitioner - Physician Assistant 4587754064 Reassigns benefits to 3 organizations
I20230426003271 MS Practitioner - Physician Assistant 4587754064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.53 of 100Reported as group
Quality
69.06
Promoting interoperability
81
Improvement activities
40
Cost
83.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince May 14, 2016 Accepting new patients
Saratoga Hospital CurrentSince May 14, 2016 Accepting new patients
Albany Medical College CurrentSince Jul 1, 2021 Accepting new patients
Albany Medical College Physician Assistant Current Accepting new patients
Albany Medical College Physician Assistant CurrentSince Jul 1, 2021 Accepting new patients

Locations

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

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

Organizations & group practices 10

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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1225227762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 MAPLE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665502",
            "telephone_number": "518-584-1656",
            "fax_number": "518-584-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 MAPLE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665502",
            "telephone_number": "518-584-1656",
            "fax_number": "518-584-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODENMAYER",
        "first_name": "WADE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00621563",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.