Upstate Dermatology, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

173589 Issued in NY

Legal business name

UPSTATE DERMATOLOGY, PC

Practice address

1547 Columbia Tpke
Castleton, NY 12033-9543

Phone

(518) 479-4156

NPI assigned

May 12, 2006

Last updated

Aug 4, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Neal Gregory, M.D.NPI 1396734513

Title

President

Phone

(518) 694-5317

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Upper Hudson Valley Dermatology, PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 19

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.

• Anthony Neal Gregory, MD MPH

  • Dermatology Physician
  • Castleton, NY
  • NPI 1396734513
  Medicare reassignment Care Compare group NPD Authorized official
• Nichelle Carter, FNP-BC

  • Family Nurse Practitioner
  • Schenectady, NY
  • NPI 1053161174
  Medicare reassignment Care Compare group NPD
• Betsy Chavez Morales, NP

  • Family Nurse Practitioner
  • Castleton, NY
  • NPI 1962247890
  Medicare reassignment Care Compare group NPD
• Michael R Dulay, MS, FNP-C

  • Family Nurse Practitioner
  • Castleton, NY
  • NPI 1528494317

  Dermatology

  Medicare reassignment Care Compare group NPD
• Albert Njoroge Huho, MB, CHB

  • Anatomic Pathology & Clinical Pathology Physician
  • Castleton, NY
  • NPI 1295014249
  Medicare reassignment Care Compare group NPD
• Amanda Kathryn O'Malley, FNP

  • Family Nurse Practitioner
  • Albany, NY
  • NPI 1356013171
  Medicare reassignment Care Compare group NPD
• Lauren Marie Rokjer, NP

  • Family Nurse Practitioner
  • Clifton Park, NY
  • NPI 1841815966
  Medicare reassignment Care Compare group NPD
• Niki Rokjer

  • Physician Assistant
  • Castleton, NY
  • NPI 1841059003
  Medicare reassignment Care Compare group NPD
• Mustafa Turkimani, PA-C

  • Physician Assistant
  • Schenectady, NY
  • NPI 1588527972
  Medicare reassignment Care Compare group NPD
• Caitlin Cook, PA

  • Physician Assistant
  • Castleton, NY
  • NPI 1184029175
  Medicare reassignment Care Compare group
• Michael Aaron Kurek, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Saratoga Springs, NY
  • NPI 1972099646
  Medicare reassignment Care Compare group
• Julia Mai, PA

  • Physician Assistant
  • Castleton, NY
  • NPI 1912628751
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1609826163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 COLUMBIA TPKE",
            "city": "CASTLETON",
            "state": "NY",
            "postal_code": "120339543",
            "telephone_number": "518-479-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 COLUMBIA TPKE",
            "city": "CASTLETON",
            "state": "NY",
            "postal_code": "120339543",
            "telephone_number": "518-479-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-694-5317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "173589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE (PTAN)",
            "identifier": "070014246",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upper Hudson Valley Dermatology, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sarah Taveras, LMSW
• Michael Andrew Thomson, M.D.
• Jaime Tice, MS CCC SLP
• Rommel Tolentino
• Aezat Ullah
• Maryann Carol Wachtel
• Walgreen Co (Walgreens #19856)
• Krista Lynn Warfield, M.D.
• Matthew Roger Weaver, LMT
• Phillip S Weisburgh, RPH

• Dermatology Physician in Castleton, NY
• Providers in Castleton, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.