Individual provider Active NPI

Daniel G Cleary

  • Nurse Practitioner
  • Latham, NY
National Provider Identifier
1346298338
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F333566 Issued in NY
Practice address
1182 Troy Schenectady Rd
Suite 100
Latham, NY 12110-1000
Phone
(518) 713-5400
Fax
(518) 713-5401
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F333566 NY Primary

Addresses

Primary practice location

1182 Troy Schenectady Rd
Suite 100
Latham, NY 12110-1000

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040709000557 NY Practitioner - Nurse Practitioner 4385622083 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F333566NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rensselaer County Bureau of Finance CurrentSince Feb 10, 2017 Accepting new patients
Rensselaer County Bureau of Finance CurrentSince Feb 10, 2017 Accepting new patients
Sunnyview Hospital and Rehabilitation Center Nurse Practitioner Past Accepting new patients

Locations

85 Bloomingrove Dr
Troy, NY 12180
Phone (212) 851-8100

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1346298338",
    "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",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 TROY SCHENECTADY RD",
            "address_2": "SUITE 100",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101000",
            "telephone_number": "518-713-5400",
            "fax_number": "518-713-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "DANIEL",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F333566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.