Individual provider Active NPI

Andrew Kovalovich

  • Audiologist
  • Schenectady, NY
National Provider Identifier
1588812846
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
001079 Issued in NY
Practice address
624 McClellan St Ste G01
Schenectady, NY 12304-1024
Phone
(518) 347-5655
Fax
(518) 347-5656
NPI assigned
Aug 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 001079 NY Primary

Addresses

Primary practice location

624 McClellan St Ste G01
Schenectady, NY 12304-1024

Mailing address

624 McClellan St Ste G01
Schenectady, NY 12304-1024
Phone (518) 347-5655

Other identifiers 5

IdentifierTypeStateIssuer
3019900OtherNYMVP
03686028MedicaidNY
000494921003OtherNYBLUE SHIELD OF NENY
200245431OtherNYCDPHP
M93091OtherNYEMPIRE BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120514000129 NY Practitioner - Qualified Audiologist 5597928440 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, shared by 13 NPIs, 1,054 clinicians

Practice addresses (Care Compare)

1769 Union St
Schenectady, NY 12309-6311
Phone (518) 264-4768

1783 Route 9
Halfmoon, NY 12065-2467
Phone (518) 262-5575

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-3277

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001079NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Dec 12, 2013 Accepting new patients
Albany Medical College Audiologist CurrentSince Aug 16, 2021 Accepting new patients
Albany Medical College CurrentSince Aug 16, 2021 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Aug 16, 2021 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Mar 2, 2024 Accepting new patients

Locations

47 New Scotland Ave
#61
Albany, NY 12208
Phone (518) 262-5791

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

35 Hackett Blvd
#1
Albany, NY 12208
Phone (518) 262-4535

624 McClellan St
Ste G01
Schenectady, NY 12304
Phone (518) 347-5655

1769 Union St
Ste 1
Schenectady, NY 12309
Phone (518) 264-4733

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

6 Executive Park Dr
Stuyvesant Plaza, NY 12203
Phone (518) 482-9111

Organizations & group practices 7

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": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1588812846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 MCCLELLAN ST STE G01",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041024",
            "telephone_number": "518-347-5655",
            "fax_number": "518-347-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MCCLELLAN ST STE G01",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041024",
            "telephone_number": "518-347-5655",
            "fax_number": "518-347-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALOVICH",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "3019900",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03686028",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NENY",
            "identifier": "000494921003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "200245431",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "M93091",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.