Individual provider Active NPI

Thomas G Portuese, MD

  • Family Medicine Physician
  • Queensbury, NY
National Provider Identifier
1407055734
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
257990 Issued in NY
Practice address
161 Carey Rd
Queensbury, NY 12804-7821
Phone
(518) 824-8610
Fax
(518) 824-2390
NPI assigned
Jul 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 257990 NY Primary

Addresses

Primary practice location

161 Carey Rd
Queensbury, NY 12804-7821

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other practice location 1

3767 Main Street
Warrensburg, NY 12885-1890
Phone (518) 623-2844

Other practice location 2

100 Broad St
Glens Falls, NY 12801-4349
Phone (518) 792-2223

Other identifiers 1

IdentifierTypeStateIssuer
03276602MedicaidNY

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address thomas.portuese.1@1823.direct.athenahealth.com
Direct Messaging Address thomas.portuese.1@1823.direct.athenahealth.com
Direct Messaging Address thomas.portuese.1@1823.direct.athenahealth.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
I20101108000030 NY Practitioner - Family Practice 3274728027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Headwaters Health NetworkGroup PAC ID 7416861208, 221 clinicians

Practice addresses (Care Compare)

100 Broad St
Glens Falls, NY 12801-4349
Phone (518) 792-2223

126 Ski Bowl Rd
North Creek, NY 12853-2607
Phone (518) 251-2541

1299 Route 9
Gansevoort, NY 12831-1560
Phone (518) 761-6961

161 Carey Rd
Queensbury, NY 12804-7821
Phone (518) 824-8610

1830 County Route 64
Salem, NY 12865-3404
Phone (518) 824-2571

24 Fairfield Ave
Schroon Lake, NY 12870-0292
Phone (518) 532-7120

Hospital & facility affiliations

  • High Peaks Hospice and Palliative Care, Inc Hospice, Hudson Falls, NY, CCN 331531
  • Community Hospice, Inc, the Hospice, Albany, NY, CCN 331501
  • Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Headwaters Health Network Family Medicine CurrentSince Sep 27, 2010 Accepting new patients
Hudson Headwaters Health Network Family Medicine Current Accepting new patients
Hudson Headwaters Health Network Family Medicine CurrentSince Sep 27, 2010 Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients

Locations

100 Broad St
Glens Falls, NY 12801
Phone (518) 792-2223

9 Carey Rd
Queensbury, NY 12804

161 Carey Rd
Queensbury, NY 12804
Phone (518) 480-0011

3767 Main St
Warrensburg, NY 12885
Phone (518) 623-2844

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 3

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1407055734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047821",
            "telephone_number": "518-824-8610",
            "fax_number": "518-824-2390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3767 Main Street",
            "address_purpose": "LOCATION",
            "city": "Warrensburg",
            "state": "NY",
            "postal_code": "128851890",
            "country_code": "US",
            "telephone_number": "518-623-2844",
            "fax_number": "518-623-3416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Broad St",
            "address_purpose": "LOCATION",
            "city": "Glens Falls",
            "state": "NY",
            "postal_code": "128014349",
            "country_code": "US",
            "telephone_number": "518-792-2223",
            "fax_number": "518-792-8231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTUESE",
        "first_name": "THOMAS",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "257990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03276602",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.portuese.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "100 Broad St",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128014349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.portuese.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "161 Carey Rd",
            "city": "Queensbury",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128047821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.portuese.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3767 Main Street",
            "city": "Warrensburg",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128851890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

Verify at the official NPI Registry.