Individual provider Active NPI

Andre Renaldo-Fernandez, MD

  • Adult Medicine Physician
  • Cobleskill, NY
National Provider Identifier
1629709852
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
326742 Issued in NY
Practice address
136 Pkwy Dr
Cobleskill, NY 12043
Phone
(518) 234-2555
NPI assigned
Jun 20, 2022
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 326742 NY Primary

Addresses

Primary practice location

136 Pkwy Dr
Cobleskill, NY 12043

Mailing address

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20250916003329 NY Practitioner - Family Practice 2365946134 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis HospitalGroup PAC ID 5890607410, 250 clinicians
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4000

136 Pkwy Dr
Cobleskill, NY 12043-5150
Phone (518) 234-2555

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3300

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
326742NYMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York CurrentSince Sep 22, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Sep 17, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Sep 17, 2025 Accepting new patients
Ellis Hospital CurrentSince Jan 24, 2026 Accepting new patients
St. Peter's Hospital of the City of Albany CurrentSince Sep 22, 2025 Accepting new patients
St. Peter's Hospital of the City of Albany CurrentSince Sep 22, 2025 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

136 Parkway Dr
Cobleskill, NY 12043
Phone (518) 234-2555

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

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

600 McClellan St
Schenectady, NY 12304
Phone (518) 382-2000

624 McClellan St
Ste 101
Schenectady, NY 12304
Phone (518) 347-5043

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

130 North St
Walton, NY 13856
Phone (607) 865-6541

Interoperability endpoints

  • Direct secure messaging: afernandez4568646@direct.trinity-health.org

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1629709852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 PKWY DR",
            "city": "COBLESKILL",
            "state": "NY",
            "postal_code": "12043",
            "telephone_number": "518-234-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENALDO-FERNANDEZ",
        "first_name": "ANDRE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NY",
            "license": "326742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SHP-Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP-Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2215 Burdett Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121802466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cobleskill, NY

Sources for this page

Verify at the official NPI Registry.