Individual provider Active NPI

Danesh Irani

  • Physician Assistant
  • Glenville, NY
National Provider Identifier
1518057272
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0047471 Issued in NY
Practice address
79 Glenridge Rd
Glenville, NY 12302-4523
Phone
(518) 952-8142
Fax
(518) 952-8109
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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 0047471 NY Primary

Addresses

Primary practice location

79 Glenridge Rd
Glenville, NY 12302-4523

Mailing address

PO Box 31094
Hartford, CT 06150-1094

Other identifiers 1

IdentifierTypeStateIssuer
02636299MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004747NYMDBehavioral Analyst
0047471NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Albany County, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dirani834584@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1518057272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31094",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061501094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 GLENRIDGE RD",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123024523",
            "telephone_number": "518-952-8142",
            "fax_number": "518-952-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRANI",
        "first_name": "DANESH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0047471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02636299",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.