Individual provider Active NPI

Stephanie Kathleen Dulay, NP

  • Family Nurse Practitioner
  • Albany, NY
National Provider Identifier
1669099750
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
346589 Issued in NY
Practice address
315 So Manning Blvd
Sparc
Albany, NY 12208-1707
Phone
(518) 525-1500
NPI assigned
Jul 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 346589 NY Primary

Addresses

Primary practice location

315 So Manning Blvd
Sparc
Albany, NY 12208-1707

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

1300 Massachusetts Avenue
Inpatient/Outpatient
Troy, NY 12180-1628
Phone (518) 268-5542

Other practice location 2

2215 Burdett Avenue
Behavioral Health
Troy, NY 12180-2466
Phone (518) 271-3554

Other practice location 3

3 Mercycare Lane
Sparc
Guilderland, NY 12084-3504
Phone (518) 452-6700

Other names 1

  • Stephanie K Koza Former name

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
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201019000190 NY Practitioner - Nurse Practitioner 1951721695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
346589NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany Family CurrentSince Sep 6, 2020 Accepting new patients
Samaritan Hospital of Troy, New York CurrentSince Sep 6, 2020 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Sep 6, 2020 Accepting new patients
Samaritan Hospital of Troy, New York CurrentSince Sep 6, 2020 Accepting new patients

Locations

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

3 Mercycare Ln
Guilderland, NY 12084
Phone (518) 452-6700

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

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

Interoperability endpoints

  • Direct secure messaging: sdulay789203@direct.trinity-health.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1669099750",
    "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": "315 SO MANNING BLVD",
            "address_2": "SPARC",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Massachusetts Avenue",
            "address_2": "Inpatient/Outpatient",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801628",
            "country_code": "US",
            "telephone_number": "518-268-5542",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Burdett Avenue",
            "address_2": "Behavioral Health",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-271-3554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Mercycare Lane",
            "address_2": "SPARC",
            "address_purpose": "LOCATION",
            "city": "Guilderland",
            "state": "NY",
            "postal_code": "120843504",
            "country_code": "US",
            "telephone_number": "518-452-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DULAY",
        "first_name": "STEPHANIE",
        "middle_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346589",
            "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": "315 So Manning Blvd",
            "address_2": "SPARC",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "KOZA",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.