Individual provider Active NPI

Katherine Sandbach McMahon, PA-C

  • Physician Assistant
  • Saratoga Springs, NY
National Provider Identifier
1265863278
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017220 Issued in NY
Practice address
19 West Ave
Suite 101
Saratoga Springs, NY 12866-6049
Phone
(518) 693-4635
Fax
(518) 682-3001
NPI assigned
Dec 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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 017220 NY Primary

Addresses

Primary practice location

19 West Ave
Suite 101
Saratoga Springs, NY 12866-6049

Mailing address

19 West Ave
Suite 101
Saratoga Springs, NY 12866-6049
Phone (518) 693-4635

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
I20140224000155 NY Practitioner - Physician Assistant 2062642887 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017220NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince Jul 11, 2016 Accepting new patients
Saratoga Hospital CurrentSince Jul 11, 2016 Accepting new patients

Locations

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

19 West Ave
Ste 101
Saratoga Springs, NY 12866
Phone (518) 587-3438

6 Care Ln
Saratoga Springs, NY 12866
Phone (518) 581-1415

Organizations & group practices 4

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": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1265863278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WEST AVE",
            "address_2": "SUITE 101",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666049",
            "telephone_number": "518-693-4635",
            "fax_number": "518-682-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WEST AVE",
            "address_2": "SUITE 101",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666049",
            "telephone_number": "518-693-4635",
            "fax_number": "518-682-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "KATHERINE",
        "middle_name": "SANDBACH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.