NPIMap

Organization Active NPI

Upstate Ny Physician PLLC

  • Emergency Medicine Physician
  • Amsterdam, NY
National Provider Identifier
1487484523
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
UPSTATE NY PHYSICIAN PLLC
Practice address
427 Guy Park Ave
Amsterdam, NY 12010-1064
Phone
(518) 842-1900
NPI assigned
Aug 5, 2024
Last updated
Jul 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Boykin Robinson, MDNPI 1689773723
Title
President
Phone
(404) 500-8147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

427 Guy Park Ave
Amsterdam, NY 12010-1064

Mailing address

400 Galleria Pkwy SE Ste 960
Atlanta, GA 30339-5980
Phone (404) 500-8147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240905002964 NY Part B Supplier - Clinic/Group Practice 4183164148 Receives reassigned benefits from 88 practitioners
Practice locations: Amsterdam, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 89

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 89

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1487484523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GALLERIA PKWY SE STE 960",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395980",
            "telephone_number": "404-500-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 GUY PARK AVE",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120101064",
            "telephone_number": "518-842-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE NY PHYSICIAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-05",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "BOYKIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-500-8147",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.