NPIMap

Individual provider Active NPI

Jennifer McGetrick, PA

  • Physician Assistant
  • Ballston Lake, NY
National Provider Identifier
1366756256
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014061 Issued in NY
Practice address
112 Charlton Rd
Ballston Lake, NY 12019-2547
Phone
(518) 399-7723
Fax
(518) 399-6428
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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 014061 NY Primary

Addresses

Primary practice location

112 Charlton Rd
Ballston Lake, NY 12019-2547

Mailing address

112 Charlton Rd
Ballston Lake, NY 12019-2547
Phone (518) 399-7723

Other identifiers 1

IdentifierTypeStateIssuer
03756663MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019000932 NY Practitioner - Physician Assistant 5294928586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians

Practice addresses (Care Compare)

112 Charlton Rd
Ballston Lake, NY 12019-2547
Phone (518) 587-8400

211 Church St
Saratoga Springs, NY 12866-1003
Phone (518) 583-8421

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014061NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince Dec 1, 2013 Accepting new patients
Scotia Glenville Family Medicine, P.C. Current Accepting new patients
Saratoga Hospital CurrentSince Dec 1, 2013 Accepting new patients
Saratoga Hospital Past Accepting new patients

Locations

112 Charlton Rd
Charlton, NY 12019
Phone (518) 399-7723

8 Medical Park Dr
Ste 100
Malta, NY 12020
Phone (518) 289-2775

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

Interoperability endpoints

  • Direct secure messaging: jmcgetrick100454@albanymed.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1366756256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CHARLTON RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192547",
            "telephone_number": "518-399-7723",
            "fax_number": "518-399-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 CHARLTON RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192547",
            "telephone_number": "518-399-7723",
            "fax_number": "518-399-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGETRICK",
        "first_name": "JENNIFER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03756663",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Lake, NY

Sources for this page

Verify at the official NPI Registry.