NPIMap

Organization Active NPI

St Peters Health Partners Medical Associates, PC

  • Internal Medicine Physician
  • Kingston, NY
National Provider Identifier
1427393149
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST PETERS HEALTH PARTNERS MEDICAL ASSOCIATES, PC
Practice address
111 Marys Ave
Suite 3
Kingston, NY 12401-5852
Phone
(845) 339-3663
Fax
(845) 339-3629
NPI assigned
Dec 6, 2012
Last updated
Jan 21, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ST PETERS HEALTH PARTNERS MEDICAL ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Authorized official

Name
Paul Gordon
Title
Dir Fin/Admin Phys Enterprise
Phone
(518) 525-1585

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X

Addresses

Primary practice location

111 Marys Ave
Suite 3
Kingston, NY 12401-5852

Mailing address

4 Atrium Dr
Suite 100
Albany, NY 12205-1441
Phone (518) 435-2740

Other names 1

  • PRIME CARE-111 MARY'S AVE- Other name

National Provider Directory

National Provider Directory
Tax ID family
Sphpma Crus Urology96 organizations share this tax ID, including this one
Part of
Sphpma Crus Urology

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4 Atrium Dr
Ste 100
Albany, NY 12205
Phone (518) 435-2704

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390262400000",
    "number": "1427393149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ATRIUM DR",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051441",
            "telephone_number": "518-435-2740",
            "fax_number": "518-649-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARYS AVE",
            "address_2": "SUITE 3",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015852",
            "telephone_number": "845-339-3663",
            "fax_number": "845-339-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PETERS HEALTH PARTNERS MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST PETERS HEALTH PARTNERS MEDICAL ASSOCIATES, PC",
        "enumeration_date": "2012-12-06",
        "last_updated": "2014-01-21",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "DIR FIN/ADMIN PHYS ENTERPRISE",
        "authorized_official_telephone_number": "518-525-1585"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIME CARE-111 MARY'S AVE-",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.