NPIMap

Individual provider Active NPI

Elise De, MD

  • Urology Physician
  • Albany, NY
National Provider Identifier
1699855619
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
236214 Issued in NY
Practice address
South Clinical Campus
23 Hackett Blvd. (MC 208)
Albany, NY 12208
Phone
(518) 262-3341
NPI assigned
Oct 16, 2006
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 236214 NY Primary

Addresses

Primary practice location

South Clinical Campus
23 Hackett Blvd. (MC 208)
Albany, NY 12208

Mailing address

25 Hackett Boulevard
Albany Med Urology Mc208
Albany, NY 12208
Phone (518) 262-3341

Other identifiers 1

IdentifierTypeStateIssuer
02662164MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20050808000305 NY Practitioner - Urology 9739118043 Reassigns benefits to 1 organization
I20170802001111 MA Practitioner - Urology 9739118043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Massachusetts Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236214NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jun 29, 2017 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Jan 1, 2022 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Jan 1, 2022 Accepting new patients
Albany Medical College CurrentSince Jan 1, 2022 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jun 29, 2017 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients

Locations

165 Cambridge St
Fl 7
Boston, MA 02114
Phone (857) 238-3838

55 Fruit St
Boston, MA 02114

55 Fruit St
#1102
Boston, MA 02114
Phone (617) 726-3010

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

23 Hackett Blvd
#208
Albany, NY 12208
Phone (518) 262-3341

25 Hackett Blvd
#208
Albany, NY 12208
Phone (518) 262-3341

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
#61
Albany, NY 12208
Phone (518) 262-5791

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

Interoperability endpoints

  • Direct secure messaging: ede20999@albanymed.direct-ci.com

Organizations & group practices 12

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1699855619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HACKETT BOULEVARD",
            "address_2": "ALBANY MED UROLOGY MC208",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-262-3341",
            "fax_number": "518-262-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTH CLINICAL CAMPUS",
            "address_2": "23 HACKETT BLVD. (MC 208)",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-262-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE",
        "first_name": "ELISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2025-02-04",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "236214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02662164",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.