NPIMap

Individual provider Active NPI

Amanda Kistler, MD

  • Vascular Surgery Physician
  • Albany, NY
National Provider Identifier
1295120962
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
333470 Issued in NY
Practice address
391 Myrtle Ave
Albany, NY 12208-3835
Phone
(518) 262-5640
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 333470 NY Primary

Addresses

Primary practice location

391 Myrtle Ave
Albany, NY 12208-3835

Mailing address

391 Myrtle Ave
Albany, NY 12208-3835
Phone (330) 978-4644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230921000504 NE Practitioner - Vascular Surgery 1850687658 Reassigns benefits to 1 organization
I20250114003183 NY Practitioner - Vascular Surgery 1850687658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2015
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)

117 Marys Ave
Suite 202
Kingston, NY 12401-5849
Phone (845) 338-1992

375 Golf Course Rd
Amsterdam, NY 12010-7506
Phone (518) 262-9600

391 Myrtle Ave
Albany, NY 12208-3835
Phone (518) 262-5640

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-3277

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)18
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians Single Specialty CurrentSince Sep 1, 2023 Accepting new patients
Albany Medical College Single Specialty CurrentSince Dec 16, 2024 Accepting new patients
Albany Medical College CurrentSince Dec 16, 2024 Accepting new patients
Albany Medical Center Hospital Past Accepting new patients
Albany Medical College Single Specialty Past Accepting new patients

Locations

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

988102 Nebraska Medical Ctr
Omaha, NE 68198
Phone (402) 559-5600

391 Myrtle Ave
Albany, NY 12208
Phone (518) 262-5588

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

391 Myrtle Ave
Ste 5
Albany, NY 12208
Phone (518) 262-7240

117 Marys Ave
Ste 202
Kingston, NY 12401
Phone (845) 338-1717

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

Interoperability endpoints

  • Direct secure messaging: akistler137348@albanymed.direct-ci.com

Organizations & group practices 5

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 9

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1295120962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 MYRTLE AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083835",
            "telephone_number": "330-978-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 MYRTLE AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083835",
            "telephone_number": "518-262-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTLER",
        "first_name": "AMANDA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "333470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.