Individual provider Active NPI

Paul B Donovan, MD

  • Hematology & Oncology Physician
  • Kingston, NY
National Provider Identifier
1326003195
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
123071 Issued in NY
Practice address
27 Grand St
Kingston, NY 12401-3933
Phone
(845) 338-1535
Fax
(845) 334-9879
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 123071 NY Primary

Addresses

Primary practice location

27 Grand St
Kingston, NY 12401-3933

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

St. Peter's Medical Oncology Hematology
317 South Manning Blvd Suite 220
Albany, NY 12208-1739
Phone (518) 525-6418

Other identifiers 1

IdentifierTypeStateIssuer
01503722MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct St. Peter's Hospital of the City of Albany

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081218000026 NY Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8022170570 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Jun 1, 2019 Accepting new patients
St. Peter'S Hospital of the City of Albany Internal Medicine CurrentSince Jan 29, 2024 Accepting new patients
St. Peter'S Hospital of the City of Albany Internal Medicine CurrentSince Jan 29, 2024 Accepting new patients
Samaritan Hospital of Troy, New York Internal Medicine CurrentSince Jan 29, 2024 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jun 1, 2019 Accepting new patients
St. Peter'S Hospitalof the City of Albany Internal Medicine Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

317 S Manning Blvd
Ste 220
Albany, NY 12208
Phone (518) 525-6418

27 Grand St
Kingston, NY 12401
Phone (845) 338-1535

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Interoperability endpoints

  • Direct secure messaging: pdonovan3144695@direct.trinity-health.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1326003195",
    "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": "27 GRAND ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013933",
            "telephone_number": "845-338-1535",
            "fax_number": "845-334-9879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "St. Peter's Medical Oncology Hematology",
            "address_2": "317 South Manning Blvd Suite 220",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081739",
            "country_code": "US",
            "telephone_number": "518-525-6418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "PAUL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "123071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01503722",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "Y",
            "endpointDescription": "SPHP Payer Credentialing",
            "affiliationName": "St. Peter's Hospital of the City of Albany",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 South Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.