Organization Active NPI

Hoosick Street Pediatrics, PLLC

  • Primary Care Clinic/Center
  • Troy, NY
National Provider Identifier
1336654052
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
203943-1 Issued in NY
Legal business name
HOOSICK STREET PEDIATRICS, PLLC
Practice address
333 Hoosick St
Troy, NY 12180-2042
Phone
(518) 273-3732
Fax
(518) 273-3732
NPI assigned
Dec 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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

Authorized official

Name
Mr. Scott Shaver
Title
Practice Manager
Phone
(518) 273-3732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 203943-1 NY Primary

Addresses

Primary practice location

333 Hoosick St
Troy, NY 12180-2042

Mailing address

333 Hoosick St
Troy, NY 12180-2042
Phone (518) 273-3732

Other identifiers 1

IdentifierTypeStateIssuer
110002411003OtherNYCAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1336654052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 HOOSICK ST",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802042",
            "telephone_number": "518-273-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 HOOSICK ST",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802042",
            "telephone_number": "518-273-3732",
            "fax_number": "518-273-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOOSICK STREET PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "518-273-3732",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "203943-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.",
            "identifier": "110002411003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.