NPIMap

Organization Active NPI

Saratoga Hospital

  • Family Medicine Physician
  • Ballston Lake, NY
National Provider Identifier
1437418795
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SARATOGA HOSPITAL
Practice address
112 Charlton Rd
Ballston Lake, NY 12019-2547
Phone
(518) 399-7723
Fax
(518) 399-6428
NPI assigned
May 8, 2012
Last updated
Apr 2, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SARATOGA HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Authorized official

Name
Kathleen Stahura
Title
Director
Phone
(518) 583-8346

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

112 Charlton Rd
Ballston Lake, NY 12019-2547

Mailing address

PO Box 412655
Boston, MA 02241-2655

Other names 1

  • SCOTIA GLENVILLE FAMILY PHYSICIANS Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040212000003 NY Part A Provider - Hospital 6406740273 17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20040402000837 NY Part B Supplier - Clinic/Group Practice 6406740273 Receives reassigned benefits from 613 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saratoga Springs, NY; Schuylerville, NY; Wilton, NY; Queensbury, NY; Saratoga, NY; Ballston Spa, NY; Galway, NY; Gansevoort, NY…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437418795. Details of each certification follow.

Hospital certification: CCN 330222

Legal name
SARATOGA HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 14, 2025
Beds
171
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 16, 1891 in NY
Enrollment address
211 Church St
Saratoga Springs, NY 12866-1003
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

Care Compare: Hospital

Medicare Care Compare
Listed as
Saratoga HospitalCCN 330222 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Saratoga Hospital

Locations

19 West Ave
Ste 103
Saratoga Springs, NY 12866
Phone (518) 583-0111

Ownership & related parties

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathleen a Stahura Individual Corporate DirectorDirector of PFS Mar 9, 1998
W-2 Managing EmployeeDirector, Patient Financial Serv Mar 9, 1998
Jill J Vankuren Individual Corporate DirectorPresident & Chief Executive Offi Sep 19, 2022
Margaret Smith Cassier Individual Corporate Officer Jan 1, 2023
Dennis P McKenna Individual Corporate OfficerBoard Member Jan 1, 2023
Heather Ward Individual Corporate OfficerBoard Member Jan 1, 2017
Albany Med Health System Organization, Albany, NY Corporation, Non-profit Operational/Managerial Control Jan 1, 2017
Thomas J Roohan Individual Corporate Officer Jan 1, 2018
Susan L Dake Individual Corporate Officer Jan 1, 2018
Michael Trimarchi Individual Corporate Officer Jan 1, 2023
Elizabeth Wood-Pustolka Individual Corporate Officer Jan 1, 2020
Christopher Jenkins Individual Corporate Director Apr 1, 2023
W-2 Managing Employee Apr 1, 2023
Patricia Gavis Individual Contracted Managing EmployeeVP & Cfo Jun 1, 2023
Corporate OfficerVP & Cfo Jun 1, 2023
Corporate Director Jun 1, 2023
W-2 Managing EmployeeVP & Cfo Jun 1, 2023
Michael Billok Individual Corporate Officer Jul 1, 2023
Frank L Messa Individual Corporate OfficerBoard Member Jan 1, 2015
Kim Hedley Individual Corporate Officer Jul 1, 2023
Raimundo C Archibold Individual Corporate Officer Jan 1, 2020
Elizabeth Sobol Individual Corporate Officer Jul 1, 2023
Saratoga Care, Inc. Organization, Saratoga Springs, NY Corporation, Non-profit Operational/Managerial Control Jan 1, 2017
Dwane Sterling Individual Corporate Officer Jul 1, 2023
Marianne a Mustafa Individual Corporate OfficerBoard Member Jan 1, 2017
David Collins Individual Corporate Officer Jan 1, 2020
Kari Cushing Individual Corporate Officer Jan 1, 2020

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 170

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 170

Affiliated clinicians 888

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 888

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1437418795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412655",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 CHARLTON RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192547",
            "telephone_number": "518-399-7723",
            "fax_number": "518-399-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARATOGA HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SARATOGA HOSPITAL",
        "enumeration_date": "2012-05-08",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A",
        "authorized_official_last_name": "STAHURA",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "518-583-8346"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCOTIA GLENVILLE FAMILY PHYSICIANS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SCOTIA GLENVILLE FAMILY PHYSICIANS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ballston Lake, NY

Sources for this page

Verify at the official NPI Registry.