Active NPI
Amanda Kathryn O'Malley, FNP
- Family Nurse Practitioner
- Albany, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 348569
- Practice address
- 4 Executive Park Dr Ste 2
Albany, NY 12203-3717 - Phone
- (518) 489-7494
- NPI assigned
- Sep 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 348569 | NY | Primary |
Addresses
Primary practice location
4 Executive Park Dr Ste 2
Albany, NY 12203-3717
Mailing address
PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634
Other practice location 1
2231 Burdett Ave Ste 160
Troy, NY 12180-2453
Phone (518) 272-1333
Other practice location 2
855 Route 146 Bldg B
Clifton Park, NY 12065-3885
Phone (518) 373-4580
Other practice location 3
319 S Manning Blvd Ste 106
Albany, NY 12208-1743
Phone (518) 438-1019
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
319 S Manning Blvd
Suite 106
Albany, NY 12208-1743
Phone (518) 438-1019
461 Clinton St Ext
Suite 1
Schenectady, NY 12305-2425
Phone (518) 374-7222
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 348569 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upstate Dermatology, PC | Current | Accepting new patients | |
| St. Peter'S Health Partners Medical Associates, P.C. | Current | Accepting new patients |
Locations
319 S Manning Blvd
Ste 106
Albany, NY 12208
Phone (518) 438-0507
4 Executive Park Dr
Ste 2
Albany, NY 12203
Phone (518) 435-1231
1547 Columbia Tpke
Castleton on Hudson, NY 12033
Phone (518) 479-4156
113 Hudson Ave
Chatham, NY 12037
Phone (518) 392-6742
855 Route 146
Bldg B
Clifton Park, NY 12065
Phone (518) 373-4580
461 Clinton St Ext
Schenectady, NY 12305
Phone (518) 374-7222
461 Clinton St Ext
#1
Schenectady, NY 12305
Phone (518) 374-7222
2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331
2231 Burdett Ave
Ste 160
Troy, NY 12180
Phone (518) 272-1333
Interoperability endpoints
- aomalley1560103@direct.trinity-health.org
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Albany, NY
- NPI 1750626834
-
- Dermatology Physician
- Castleton, NY
- NPI 1609826163
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Troy, NY
- NPI 1043267727
-
- General Acute Care Hospital
- Albany, NY
- NPI 1497701106
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1356013171",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 EXECUTIVE PARK DR STE 2",
"city": "ALBANY",
"state": "NY",
"postal_code": "122033717",
"telephone_number": "518-489-7494"
}
],
"practiceLocations": [
{
"address_1": "2231 Burdett Ave Ste 160",
"address_purpose": "LOCATION",
"city": "Troy",
"state": "NY",
"postal_code": "121802453",
"country_code": "US",
"telephone_number": "518-272-1333",
"fax_number": "518-272-1331",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "855 Route 146 Bldg B",
"address_purpose": "LOCATION",
"city": "Clifton Park",
"state": "NY",
"postal_code": "120653885",
"country_code": "US",
"telephone_number": "518-373-4580",
"fax_number": "518-489-7641",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "319 S Manning Blvd Ste 106",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122081743",
"country_code": "US",
"telephone_number": "518-438-1019",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "O'MALLEY",
"first_name": "AMANDA",
"middle_name": "KATHRYN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-30",
"last_updated": "2021-12-14",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "348569",
"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": "319 S Manning Blvd Ste 106",
"city": "Albany",
"state": "NY",
"country_code": "US",
"postal_code": "122081743",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.