Individual provider Active NPI

Patricia Brady, P.A.

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1366438392
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005209 Issued in NY
Practice address
400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5013
Phone
(518) 489-0044
NPI assigned
Sep 26, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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 005209 NY Primary

Addresses

Primary practice location

400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5013

Mailing address

400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5013
Phone (518) 489-0044

Other identifiers 2

IdentifierTypeStateIssuer
70034AOtherNYMEDICARE GRP
P01114053OtherNYRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5209NYMDOptician
005209NYMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: patricia.brady@nyoh.ikm.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1366438392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PATROON CREEK BLVD",
            "address_2": "SUITE 1",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122065013",
            "telephone_number": "518-489-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PATROON CREEK BLVD",
            "address_2": "SUITE 1",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122065013",
            "telephone_number": "518-489-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "PATRICIA",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP",
            "identifier": "70034A",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01114053",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "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 Mar 19, 2019; 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.