Individual provider Active NPI

Maura Rose Brondi, PA

  • Physician Assistant
  • Schenectady, NY
National Provider Identifier
1528593423
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020798 Issued in NY
Practice address
1101 Nott St
Department of Emergency
Schenectady, NY 12308-2425
Phone
(518) 243-1916
Fax
(518) 243-1853
NPI assigned
Apr 28, 2017
Last updated
May 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NY
Physician Assistant 363A00000X 020798 NY Primary

Addresses

Primary practice location

1101 Nott St
Department of Emergency
Schenectady, NY 12308-2425

Mailing address

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

Other practice location 1

2546 Balltown Rd Ste 300
Schenectady, NY 12309-1079
Phone (518) 377-8184

Other practice location 2

3757 Carman Rd Ste 103
Schenectady, NY 12303-5438
Phone (518) 881-0810

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20170720000419 NY Practitioner - Physician Assistant 2567732712 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
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

23 Arterial PLZ
30 A
Gloversville, NY 12078-2512
Phone (518) 773-2303

2546 Balltown Rd
Suite 300
Schenectady, NY 12309-1079
Phone (518) 377-8184

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020798NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Jun 1, 2017 Accepting new patients
St. Peter's Health Partners Medical Associates, P.C. Physician Assistant CurrentSince May 10, 2021 Accepting new patients
St. Peter's Health Partners Medical Associates, P.C. Physician Assistant Past Accepting new patients

Locations

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

2546 Balltown Rd
Ste 300
Schenectady, NY 12309
Phone (518) 377-8184

3757 Carman Rd
Ste 103
Schenectady, NY 12303
Phone (518) 374-7371

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

Interoperability endpoints

  • Direct secure messaging: mbrondi@caspc.medentdirect.com

Organizations & group practices 4

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 2

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": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1528593423",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NOTT ST",
            "address_2": "DEPARTMENT OF EMERGENCY",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082425",
            "telephone_number": "518-243-1916",
            "fax_number": "518-243-1853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2546 Balltown Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123091079",
            "country_code": "US",
            "telephone_number": "518-377-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3757 Carman Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123035438",
            "country_code": "US",
            "telephone_number": "518-881-0810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRONDI",
        "first_name": "MAURA",
        "middle_name": "ROSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP- Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2546 Balltown Rd Ste 300",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123091079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.