NPIMap

Individual provider Active NPI

Kerron Andrew Gilford, PA

  • Medical Physician Assistant
  • Schenectady, NY
National Provider Identifier
1659781110
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
017504-1 Issued in NY
Practice address
1270 Belmont Ave
Schenectady, NY 12308-2104
Phone
(518) 382-4560
Fax
(518) 386-3619
NPI assigned
May 5, 2014
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 017504-1 NY Primary

Addresses

Primary practice location

1270 Belmont Ave
Schenectady, NY 12308-2104

Mailing address

PO Box 14890
Albany, NY 12212-4890

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX, PA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180516001601 NY Practitioner - Physician Assistant 5395967640 Reassigns benefits to 1 organization
I20211014001263 TX Practitioner - Physician Assistant 5395967640 Reassigns benefits to 2 organizations
I20231115002810 PA Practitioner - Physician Assistant 5395967640 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunnyview Hospital and Rehabilitation CenterGroup PAC ID 5496743072, 31 clinicians

Practice addresses (Care Compare)

1270 Belmont Ave
Schenectady, NY 12308-2104
Phone (518) 382-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Apr 24, 2024 Accepting new patients
University of Penn - Medical Group CurrentSince Aug 21, 2023 Accepting new patients
Vpa of Texas PLLC Medical CurrentSince Apr 24, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Aug 21, 2023 Accepting new patients

Locations

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Interoperability endpoints

  • Direct secure messaging: kgilford151687@direct.phhs.org
  • Direct secure messaging: kgilford3509321@direct.trinity-health.org

Organizations & group practices 8

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 1

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": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1659781110",
    "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": "1270 BELMONT AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082104",
            "telephone_number": "518-382-4560",
            "fax_number": "518-386-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILFORD",
        "first_name": "KERRON",
        "middle_name": "ANDREW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-05",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "017504-1",
            "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": "1270 Belmont Ave",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123082104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.