NPIMap

Organization Active NPI

Gastroenterology Associates of Northern New York PC

  • Gastroenterology Physician
  • Glens Falls, NY
National Provider Identifier
1376583641
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROENTEROLOGY ASSOCIATES OF NORTHERN NEW YORK PC
Practice address
5 Irongate Center
Glens Falls, NY 12801
Phone
(518) 793-5034
Fax
(518) 793-2951
NPI assigned
Jun 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kevin J Herlihy, MDNPI 1891790101
Title
President
Phone
(518) 793-5034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

5 Irongate Center
Glens Falls, NY 12801

Mailing address

5 Irongate Center
Glens Falls, NY 12801
Phone (518) 793-5034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041116000388 NY Part B Supplier - Clinic/Group Practice 9032173430 Receives reassigned benefits from 11 practitioners
Practice locations: Fort Edward, NY; Glens Falls, NY

National Provider Directory

National Provider Directory

Locations

1 Myrtle Ave
Cambridge, NY 12816
Phone (518) 252-2561

1391 Route 9
Fort Edward, NY 12828
Phone (518) 793-0891

6 Carpenter Ln
Saratoga Springs, NY 12866
Phone (518) 583-0020

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376583641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 IRONGATE CENTER",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "12801",
            "telephone_number": "518-793-5034",
            "fax_number": "518-793-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 IRONGATE CENTER",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "12801",
            "telephone_number": "518-793-5034",
            "fax_number": "518-793-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY ASSOCIATES OF NORTHERN NEW YORK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERLIHY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-793-5034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.