Individual provider Active NPI

Tricia Fullerton, DO

  • Anesthesiology Physician
  • Albany, NY
National Provider Identifier
1396033130
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
300780 Issued in NY
Practice address
1450 Western Ave
Suite 102
Albany, NY 12203-3539
Phone
(518) 463-0050
Fax
(518) 207-2973
NPI assigned
Jul 14, 2011
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 20A12428 CA
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 300780 NY Primary

Addresses

Primary practice location

1450 Western Ave
Suite 102
Albany, NY 12203-3539

Mailing address

1450 Western Ave
Suite 102
Albany, NY 12203-3539
Phone (518) 463-0050

Other practice location 1

327 Beach 19th St
Far Rockaway, NY 11691-4423
Phone (718) 869-7000

Other practice location 2

259 1st St
Mineola, NY 11501-3957
Phone (516) 663-2216

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tfullerton500719@nyumc.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191213000172 NY Practitioner - Anesthesiology 7012299894 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schenectady Anesthesia Associates, P.C.Group PAC ID 5294628087, 43 clinicians
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

16 Maxwell Dr
Clifton Park, NY 12065-2920
Phone (518) 489-2663

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

Merit-based Incentive Payment System (MIPS)

Final score
43.71 of 100Reported as group
Quality
30.53
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A12428CAMDAnesthesiology Physician
12428CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince May 17, 2022 Accepting new patients
Albany Medical College CurrentSince Jun 10, 2023 Accepting new patients
Albany Medical College Current Accepting new patients
Schenectady Anesthesia Associates, P.C. Anesthesiology CurrentSince Jun 1, 2023 Accepting new patients
Albany Medical College Anesthesiology CurrentSince Jun 10, 2023 Accepting new patients
Albany Medical College Anesthesiology Current Accepting new patients
Albany Medical College Anesthesiology CurrentSince Jun 10, 2023 Accepting new patients
New York University Anesthesiology Current Accepting new patients
New York University Anesthesiology CurrentSince May 17, 2022 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

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

47 New Scotland Ave
#131
Albany, NY 12208
Phone (518) 262-4300

16 Maxwell Dr
Clifton Park, NY 12065
Phone (518) 557-1800

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

1201 Nott St
Ste 106
Schenectady, NY 12308
Phone (518) 374-3123

Interoperability endpoints

  • Direct secure messaging: tfullerton24678@albanymed.direct-ci.com
  • Direct secure messaging: tfullerton500719@nyumc.direct-ci.com
  • Direct secure messaging: tfullerton788239@direct.trinity-health.org

Organizations & group practices 9

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1396033130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 WESTERN AVE",
            "address_2": "SUITE 102",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033539",
            "telephone_number": "518-463-0050",
            "fax_number": "518-207-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 WESTERN AVE",
            "address_2": "SUITE 102",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033539",
            "telephone_number": "518-463-0050",
            "fax_number": "518-207-2973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Beach 19th St",
            "address_purpose": "LOCATION",
            "city": "Far Rockaway",
            "state": "NY",
            "postal_code": "116914423",
            "country_code": "US",
            "telephone_number": "718-869-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "259 1st St",
            "address_purpose": "LOCATION",
            "city": "Mineola",
            "state": "NY",
            "postal_code": "115013957",
            "country_code": "US",
            "telephone_number": "516-663-2216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "TRICIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "20A12428",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "300780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfullerton500719@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "259 1st St",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.