Individual provider Active NPI

Alexandra Noelle Sutherland, PA-C

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1700644614
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
43 New Scotland Ave
Albany, NY 12208-3478
Phone
(518) 262-3125
NPI assigned
Mar 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

43 New Scotland Ave
Albany, NY 12208-3478

Mailing address

455 Saddle Back Ridge Rd
East Nassau, NY 12062-2031

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
I20240823001661 NY Practitioner - Physician Assistant 3971042839 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031626NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Jun 8, 2024 Accepting new patients
Albany Medical College Physician Assistant Past Accepting new patients

Locations

43 New Scotland Ave
Albany, NY 12208
Phone (518) 262-5149

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

22 New Scotland Ave
Fl 3
Albany, NY 12208
Phone (518) 262-5332

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

Interoperability endpoints

  • Direct secure messaging: asutherland88975@albanymed.direct-ci.com

Organizations & group practices 3

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": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1700644614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SADDLE BACK RIDGE RD",
            "city": "EAST NASSAU",
            "state": "NY",
            "postal_code": "120622031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083478",
            "telephone_number": "518-262-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "ALEXANDRA",
        "middle_name": "NOELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.