NPIMap

Organization Active NPI

Samaritan Hospital of Troy, New York

  • Pediatrics Physician
  • Clifton Park, NY
National Provider Identifier
1497239453
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SAMARITAN HOSPITAL OF TROY, NEW YORK
Practice address
1 Tallow Wood Drive
Clifton Park, NY 12065-2807
Phone
(518) 688-0295
NPI assigned
Sep 17, 2018
Last updated
Oct 11, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMARITAN HOSPITAL OF TROY, NEW YORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Courtney Knowles
Title
Credentialing Manager
Phone
(518) 525-5634

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
General Acute Care Hospital 282N00000X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Midwife 176B00000X
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

1 Tallow Wood Drive
Clifton Park, NY 12065-2807

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other names 1

  • Pediatrics - St. Peter's Pediatrics Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct Samaritan Hospital of Troy, New York

National Provider Directory

National Provider Directory
Tax ID family
Amelia M Dodge MD27 organizations share this tax ID, including this one
Part of
Amelia M Dodge MD

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1497239453",
    "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": "1 TALLOW WOOD DRIVE",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652807",
            "telephone_number": "518-688-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN HOSPITAL OF TROY, NEW YORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMARITAN HOSPITAL OF TROY, NEW YORK",
        "enumeration_date": "2018-09-17",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-525-5634"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "Y",
            "endpointDescription": "SPHP Payer Credentialing",
            "affiliationName": "Samaritan Hospital of Troy, New York",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1 Tallow Wood Drive",
            "city": "Clifton Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "120652807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pediatrics - St. Peter's Pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.