Individual provider Active NPI

Jacob Walling

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1467254540
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
319 S Manning Blvd Ste 106
Albany, NY 12208-1743
Phone
(518) 438-1019
Fax
(518) 438-0981
NPI assigned
Mar 27, 2025
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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 Primary

Addresses

Primary practice location

319 S Manning Blvd Ste 106
Albany, NY 12208-1743

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

4 Executive Park Dr Ste 2
Albany, NY 12203-3717
Phone (518) 489-7494

Other practice location 2

1735 Route 9
Halfmoon, NY 12065-2421
Phone (518) 525-1789

Other practice location 3

2231 Burdett Ave Ste 160
Troy, NY 12180-2453
Phone (518) 272-1333

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
I20250828002663 NY Practitioner - Physician Assistant 2668973926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1852

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034044NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Health Partners Medical Associates, P.C. Physician Assistant CurrentSince Aug 18, 2025 Accepting new patients

Locations

319 S Manning Blvd
Ste 106
Albany, NY 12208
Phone (518) 438-0507

4 Executive Park Dr
Ste 2
Albany, NY 12203
Phone (518) 435-1231

1735 Route 9
Halfmoon, NY 12065
Phone (518) 269-4690

2231 Burdett Ave
Ste 160
Troy, NY 12180
Phone (518) 292-6200

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

Interoperability endpoints

  • Direct secure messaging: jwalling4515270@direct.trinity-health.org

Organizations & group practices 1

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 1

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": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1467254540",
    "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",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S MANNING BLVD STE 106",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081743",
            "telephone_number": "518-438-1019",
            "fax_number": "518-438-0981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Executive Park Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122033717",
            "country_code": "US",
            "telephone_number": "518-489-7494",
            "fax_number": "518-489-7641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1735 Route 9",
            "address_purpose": "LOCATION",
            "city": "Halfmoon",
            "state": "NY",
            "postal_code": "120652421",
            "country_code": "US",
            "telephone_number": "518-525-1789",
            "fax_number": "518-776-2785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2231 Burdett Ave Ste 160",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802453",
            "country_code": "US",
            "telephone_number": "518-272-1333",
            "fax_number": "518-272-1331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLING",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.