St. Peter's Hospital of the City of Albany

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

ST. PETER'S HOSPITAL OF THE CITY OF ALBANY

Practice address

1300 Massachusetts Ave
Troy, NY 12180-1628

Phone

(518) 268-5542

Fax

(518) 268-5324

NPI assigned

Dec 22, 2006

Organization subpart

Yes

Parent organization

ST. PETER'S HOSPITAL OF THE CITY OF ALBANYAs reported in NPPES

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

Authorized official

Name

Courtney Knowles

Title

Credentialing & Enrollment Manager

Phone

(518) 525-5634

Specialties & licenses 14

Addresses

Other names 1

• St. Mary's Campus Addiction Recovery Center Other name

Electronic endpoints 1

Tax ID family

Robert W Kelty25 organizations share this tax ID, including this one

Part of

Robert W Kelty

Other organizations with this tax ID 24

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

• St Peter's Lifeline

  • Emergency Response System Companies
  • Albany, NY
  • NPI 1003110479
  NPD tax ID
• St Peters Hospital

  dba St Peters NICU Department

  • Specialist
  • Albany, NY
  • NPI 1205981792
  NPD tax ID
• St Peters Hospital Outpatient Pharmacy

  • Institutional Pharmacy
  • Albany, NY
  • NPI 1619191806
  NPD tax ID
• St. Peter's Addiction Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Albany, NY
  • NPI 1487975645
  NPD tax ID
• St. Peter's Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1881885176
  NPD tax ID
• St. Peter's Hospital

  dba St. Peter's Hospital Breast Surgery

  • Surgical Oncology Physician
  • Albany, NY
  • NPI 1881997104
  NPD tax ID
• St. Peter's Hospital of the City of Albany

  • Durable Medical Equipment & Medical Supplies
  • Albany, NY
  • NPI 1053466425
  NPD tax ID
• St. Peter's Hospital of the City of Albany

  • Orthopaedic Surgery Physician
  • Latham, NY
  • NPI 1063227544
  NPD tax ID
• St. Peter's Hospital of the City of Albany

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Albany, NY
  • NPI 1063885788
  NPD tax ID
• St. Peter's Hospital of the City of Albany

  • Hematology & Oncology Physician
  • Albany, NY
  • NPI 1144407024
  NPD tax ID
• St. Peter's Hospital of the City of Albany

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Latham, NY
  • NPI 1194943670
  NPD tax ID
• St. Peter's Hospital of the City of Albany

  • Sleep Medicine (Internal Medicine) Physician
  • Albany, NY
  • NPI 1245682442
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd J Whitman, MD

  • Hematology & Oncology Physician
  • Plattsburgh, NY
  • NPI 1073585055

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1609931443",
    "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": "1300 MASSACHUSETTS AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121801628",
            "telephone_number": "518-268-5542",
            "fax_number": "518-268-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETER'S HOSPITAL OF THE CITY OF ALBANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. PETER'S HOSPITAL OF THE CITY OF ALBANY",
        "enumeration_date": "2006-12-22",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CREDENTIALING & ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "518-525-5634"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NY",
            "license": "074304-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "Y",
            "endpointDescription": "SPHP Payer Credentialing",
            "affiliationName": "St. Peter's Hospital of the City of Albany",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1300 Massachusetts Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121801628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St. Mary's Campus Addiction Recovery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• St. Peter's Health Partners Medical Associates, P.C.
• St. Peter's Health Partners Medical Associates, P.C.
• St. Peter's Health Partners Medical Associates, P.C.
• St. Peter's Health Partners Medical Associates, PC
• St. Peter's Health Partners Medical Associates, PC
• Kathryn Stackrow, PT, DPT
• Zachary Stahlman, CRPA
• Constance Apple Stalker, FNP
• Karen M Stanley White, BS PT
• Alfonso Starja, PT, DPT

• Substance Use Disorder Rehabilitation Clinic/Center in Troy, NY
• Providers in Troy, NY by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.