NPIMap

Individual provider Active NPI

Timothy Patrick Holley, PA

  • Physician Assistant
  • Saratoga Springs, NY
National Provider Identifier
1326611674
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
026822 Issued in NY
Practice address
1 West Ave Ste 330
Saratoga Springs, NY 12866-6065
Phone
(518) 584-5330
Fax
(518) 583-7663
NPI assigned
Jul 22, 2021
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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 026822 NY Primary

Addresses

Primary practice location

1 West Ave Ste 330
Saratoga Springs, NY 12866-6065

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156

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
I20211013001090 NY Practitioner - Physician Assistant 3779981295 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians
Healthcare Partners of Saratoga LTDGroup PAC ID 9739320938, 75 clinicians

Practice addresses (Care Compare)

1 W Ave
Suite 300
Saratoga Springs, NY 12866-6050
Phone (518) 693-4699

1 W Ave
Suite 330
Saratoga Springs, NY 12866-6065
Phone (518) 584-5330

3040 Route 50
Saratoga Springs, NY 12866-3073
Phone (518) 580-2273

3044 Route 50
Saratoga Springs, NY 12866-3073
Phone (518) 886-5800

6 Medical Park Dr
Malta, NY 12020-5051
Phone (518) 289-2020

6 Wellness Way
Latham, NY 12110-2156
Phone (518) 782-3700

711 Troy Schenectady Rd
Latham, NY 12110-2461

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince Dec 16, 2025 Accepting new patients
St Marys Healthcare CurrentSince Sep 7, 2021 Accepting new patients
Healthcare Partners of Saratoga LTD CurrentSince Dec 16, 2025 Accepting new patients
St. Mary's Healthcare CurrentSince Sep 7, 2021 Accepting new patients
Saratoga Hospital CurrentSince Dec 16, 2025 Accepting new patients
Community Care Physicians, PC PastSince Jun 16, 2024 Accepting new patients

Locations

380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

6 Medical Park Dr
Malta, NY 12020
Phone (518) 289-2020

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1326611674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WEST AVE STE 330",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666065",
            "telephone_number": "518-584-5330",
            "fax_number": "518-583-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "TIMOTHY",
        "middle_name": "PATRICK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-22",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.