NPIMap

Organization Active NPI

St. Peter'S Hospitalof the City of Albany

  • Dentist
  • Albany, NY
National Provider Identifier
1629470919
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ST. PETER'S HOSPITALOF THE CITY OF ALBANY
Practice address
1092 Madison Avenue 2ND FLR
Albany, NY 12208-2248
Phone
(518) 525-1757
NPI assigned
Sep 18, 2014
Organization subpart
Yes
Parent organization
ST. PETER'S HOSPITAL OF THE CITY OF ALBANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Courtney Knowles
Title
Credentialing Manager
Phone
(518) 525-5634

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
Dental Clinic/Center 261QD0000X
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

1092 Madison Avenue 2ND FLR
Albany, NY 12208-2248

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other names 1

  • SPH Dental Group Practice Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct St. Peter's Hospital of the City of Albany

National Provider Directory

National Provider Directory
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.

View all 24

Locations

1092 Madison Ave
Fl 2
Albany, NY 12208
Phone (518) 525-1757

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1629470919",
    "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": "1092 MADISON AVENUE 2ND FLR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082248",
            "telephone_number": "518-525-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETER'S HOSPITALOF THE CITY OF ALBANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. PETER'S HOSPITAL OF THE CITY OF ALBANY",
        "enumeration_date": "2014-09-18",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-525-5634"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "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": "1092 Madison Avenue 2nd Flr",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122082248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SPH Dental Group Practice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.