Jacquelyn McLean Bennett, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

212729 Issued in NY

Practice address

79 Vandenburgh Ave
Troy, NY 12180-6024

Phone

(518) 271-0063

Fax

(518) 271-0298

NPI assigned

Jul 31, 2006

Last updated

Feb 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eddy Visiting Nurse & Rehab Association Home health agency, Troy, NY, CCN 337203
• Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
• St Peter's Hospital Hospital, Albany, NY, CCN 330057
• Sunnyview Hospital and Rehabilitation Center Hospital, Schenectady, NY, CCN 330406

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmcleanbennett834639@direct.trinity-health.org

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.

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727

  Family Medicine

  Medicare reassignment Care Compare group NPD
• St. Peter's Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834

  Family Medicine

  Medicare reassignment NPD
• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370

  Family Medicine

  NPD (past)

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

• Home Aide Service of Eastern New York, Inc.

  dba Eddy Visiting Nurse Association

  • Home Health Agency
  • Troy, NY
  • NPI 1114967924
  Care Compare affiliation
• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  Care Compare affiliation
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation
• Sunnyview Hospital and Rehabilitation Center

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1578664470
  Care Compare affiliation

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1639185416",
    "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",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 VANDENBURGH AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121806024",
            "telephone_number": "518-271-0063",
            "fax_number": "518-271-0298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1375 Washington Ave",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "12206",
            "country_code": "US",
            "telephone_number": "518-482-0007",
            "fax_number": "518-482-0008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Patroon Creek Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122065014",
            "country_code": "US",
            "telephone_number": "518-618-1100",
            "fax_number": "518-618-1663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEAN BENNETT",
        "first_name": "JACQUELYN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "212729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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": "79 Vandenburgh Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121806024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Colette McKelvey
• Dennis McKevitt, MD
• Nancy Marie McKillip, MS ED.
• Cassandra M McLaughlin
• Jennifer McLaughlin, RN
• Carley R McLean, RN
• Michael McLoughlin, LMSW
• Ashley L McNally, MS, CCC-SLP
• Madeline Marie McQuail, LCSW
• Mediaide LLC

• Family Medicine Physician in Troy, NY
• Providers in Troy, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.