NPIMap

Individual provider Active NPI

Erin Shooshan, PA

  • Medical Physician Assistant
  • Queensbury, NY
National Provider Identifier
1396749909
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
007530 Issued in NY
Practice address
6 Hearts Way
Adirondack Cardiology
Queensbury, NY 12804
Phone
(518) 792-1233
Fax
(518) 792-6854
NPI assigned
Jun 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 007530 NY Primary

Addresses

Primary practice location

6 Hearts Way
Adirondack Cardiology
Queensbury, NY 12804

Mailing address

100 Park Street
Glens Falls Hospital - Credentialing
Glens Falls, NY 12801-4413
Phone (518) 926-5924

Other identifiers 1

IdentifierTypeStateIssuer
02347840MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address erin.judge@cdirectglensfallshosp.org

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
I20031230000611 NY Practitioner - Physician Assistant 3577461318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians

Practice addresses (Care Compare)

211 Church St
Saratoga Springs, NY 12866-1003
Phone (518) 886-5080

Hospital & facility affiliations

  • Saratoga Hospital Hospital, Saratoga Springs, NY, CCN 330222
  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

Merit-based Incentive Payment System (MIPS)

Final score
68.51 of 100Reported as group
Quality
56.19
Improvement activities
40
Cost
75.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007530NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince Mar 24, 2023 Accepting new patients
Saratoga Hospital CurrentSince Mar 24, 2023 Accepting new patients
Saratoga Hospital Past Accepting new patients

Locations

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

6 Medical Park Dr
Ste 205
Malta, NY 12020
Phone (518) 583-0111

6 Medical Park Dr
Ste 206
Malta, NY 12020
Phone (518) 289-2718

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

254 Church St
Ste 2
Saratoga Springs, NY 12866
Phone (518) 584-3377

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1396749909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK STREET",
            "address_2": "GLENS FALLS HOSPITAL - CREDENTIALING",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-5924",
            "fax_number": "518-926-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HEARTS WAY",
            "address_2": "ADIRONDACK CARDIOLOGY",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "12804",
            "telephone_number": "518-792-1233",
            "fax_number": "518-792-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOSHAN",
        "first_name": "ERIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02347840",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erin.judge@cdirectglensfallshosp.org",
            "affiliation": "N",
            "address_1": "6 Hearts Way",
            "address_2": "Adirondack Cardiology",
            "city": "Queensbury",
            "state": "NY",
            "country_code": "US",
            "postal_code": "12804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

Verify at the official NPI Registry.