Individual provider Active NPI

Allyson Elayne Quinn, PA-C

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1417733940
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
031028 Issued in NY
Practice address
63 Shaker Rd Ste 201
Albany, NY 12204-1030
Phone
(518) 471-3636
Fax
(518) 471-3668
NPI assigned
Aug 31, 2023
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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 031028 NY Primary

Addresses

Primary practice location

63 Shaker Rd Ste 201
Albany, NY 12204-1030

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

855 Route 146 Ste 150
Clifton Park, NY 12065-3874
Phone (518) 471-3636

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231213003980 NY Practitioner - Physician Assistant 7517316631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2 New Hampshire Ave
Troy, NY 12180-1764
Phone (518) 525-8220

63 Albany Shaker Rd
Suite 102
Albany, NY 12204-1030
Phone (518) 429-2561

63 Shaker Rd
Albany, NY 12204-1030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031028NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Health Partners Medical Associates, P.C. Physician Assistant CurrentSince Nov 7, 2023 Accepting new patients
St. Peter's Health Partners Medical Associates, P.C. Physician Assistant Past Accepting new patients

Locations

63 Shaker Rd
Ste 201
Albany, NY 12204
Phone (518) 446-1850

855 Route 146
Ste 150
Clifton Park, NY 12065
Phone (518) 292-6200

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: aquinn790177@direct.trinity-health.org

Organizations & group practices 2

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 2

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": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1417733940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SHAKER RD STE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122041030",
            "telephone_number": "518-471-3636",
            "fax_number": "518-471-3668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 Route 146 Ste 150",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120653874",
            "country_code": "US",
            "telephone_number": "518-471-3636",
            "fax_number": "518-471-3668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINN",
        "first_name": "ALLYSON",
        "middle_name": "ELAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "63 Shaker Rd Ste 201",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122041030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.