Individual provider Active NPI

Amine F Gebremichael, MD

  • Pediatrics Physician
  • Gansevoort, NY
National Provider Identifier
1629394622
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
272530 Issued in NY
Practice address
1299 Route 9
Gansevoort, NY 12831-1560
Phone
(518) 761-6961
Fax
(518) 761-1006
NPI assigned
Apr 15, 2010
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 272530 NY Primary

Addresses

Primary practice location

1299 Route 9
Gansevoort, NY 12831-1560

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other identifiers 1

IdentifierTypeStateIssuer
03686362MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amine.gebremichael.1@1823.direct.athenahealth.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170717002286 NY Practitioner - Pediatric Medicine 8921321001 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
272530NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Headwaters Health Network Pediatrics CurrentSince Feb 20, 2018 Accepting new patients
Glens Falls Hospital Inc. Pediatrics CurrentSince Jul 1, 2017 Accepting new patients
Glens Falls Hospital Inc CurrentSince Jul 1, 2017 Accepting new patients
Hudson Headwaters Health Network Pediatrics CurrentSince Feb 20, 2018 Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients
Glens Falls Hospital Inc Past Accepting new patients

Locations

1299 Route 9
Gansevoort, NY 12831
Phone (518) 761-6961

79 North St
Granville, NY 12832
Phone (518) 642-0612

9 Carey Rd
Queensbury, NY 12804

Interoperability endpoints

  • Direct secure messaging: agebremichael98730@albanymed.direct-ci.com
  • Direct secure messaging: amine.gebremichael.1@1823.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1629394622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 ROUTE 9",
            "city": "GANSEVOORT",
            "state": "NY",
            "postal_code": "128311560",
            "telephone_number": "518-761-6961",
            "fax_number": "518-761-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREMICHAEL",
        "first_name": "AMINE",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "272530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03686362",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amine.gebremichael.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1299 Route 9",
            "city": "Gansevoort",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128311560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gansevoort, NY

Sources for this page

Verify at the official NPI Registry.