Individual provider Active NPI

Elizabeth Anne Nardacci, NP

  • Nurse Practitioner
  • Albany, NY
National Provider Identifier
1356330351
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
331792-1 Issued in NY
Practice address
63 Shaker Road
Suite 201
Albany, NY 12204
Phone
(518) 471-3636
Fax
(518) 471-3668
NPI assigned
Oct 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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 331792-1 NY Primary

Addresses

Primary practice location

63 Shaker Road
Suite 201
Albany, NY 12204

Mailing address

PO Box 14890
SPHP Payer Credentialing
Albany, NY 12212
Phone (518) 591-1121

Other identifiers 1

IdentifierTypeStateIssuer
01927417MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101105000254 NY Practitioner - Nurse Practitioner 9830383694 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
331792-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Mar 1, 1998 Accepting new patients
Albany Medical College Nurse Practitioner CurrentSince Mar 1, 1998 Accepting new patients
Albany Medical College Current Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Nurse Practitioner CurrentSince Sep 1, 2014 Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

16 New Scotland Ave
Albany, NY 12208
Phone (518) 262-4942

63 Shaker Rd
Ste G01
Albany, NY 12204
Phone (518) 391-2973

63 Shaker Rd
Ste 201
Albany, NY 12204
Phone (518) 446-1850

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: enardacci852977@direct.trinity-health.org

Organizations & group practices 4

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1356330351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "address_2": "SPHP PAYER CREDENTIALING",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12212",
            "telephone_number": "518-591-1121",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SHAKER ROAD",
            "address_2": "SUITE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12204",
            "telephone_number": "518-471-3636",
            "fax_number": "518-471-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARDACCI",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "331792-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01927417",
            "state": "NY"
        }
    ],
    "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": "63 Shaker Road",
            "address_2": "Suite 201",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "12204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.