NPIMap

Individual provider Active NPI

Obafemi O Giwa-Amu, M.D.

  • Family Medicine Physician
  • Gloversville, NY
National Provider Identifier
1295256584
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
306246 Issued in NY
Practice address
99 E State St
Gloversville, NY 12078-1293
Phone
(518) 773-5690
NPI assigned
Jun 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 306246 NY Primary

Addresses

Primary practice location

99 E State St
Gloversville, NY 12078-1293

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

1444 Western Ave Ste A
Albany, NY 12203-3458
Phone (518) 489-2812

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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210401002155 NY Practitioner - Family Practice 9638586985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1444 Western Ave
Suite a
Albany, NY 12203-3458
Phone (518) 489-2812

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306246NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health Partners Medical Associates, P.C. Family Medicine CurrentSince Mar 5, 2024 Accepting new patients
Nathan Littauer Hospital Association Past Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Past Accepting new patients

Locations

1444 Western Ave
Ste A
Albany, NY 12203
Phone (518) 489-2812

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

Interoperability endpoints

  • Direct secure messaging: ogiwaamu3181612@direct.trinity-health.org
  • Direct secure messaging: oamu@nlh.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.

Hospital & facility affiliations 11

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": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1295256584",
    "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": "99 E STATE ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781293",
            "telephone_number": "518-773-5690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1444 Western Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122033458",
            "country_code": "US",
            "telephone_number": "518-489-2812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIWA-AMU",
        "first_name": "OBAFEMI",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "306246",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Ave Ste A",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122033458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gloversville, NY

Sources for this page

Verify at the official NPI Registry.