Individual provider Active NPI

Paula S. Zimmer

  • Acute Care Nurse Practitioner
  • Glens Falls, NY
National Provider Identifier
1700816568
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F4300063 Issued in NY
Practice address
100 Park St
Hospitalist Program
Glens Falls, NY 12801-4413
Phone
(518) 926-5918
Fax
(518) 926-5917
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F4300063 NY Primary

Addresses

Primary practice location

100 Park St
Hospitalist Program
Glens Falls, NY 12801-4413

Mailing address

22 Crawford Dr
Ballston Lake, NY 12019-2740
Phone (518) 384-1507

Other identifiers 1

IdentifierTypeStateIssuer
02968032MedicaidNY

Other names 1

  • Mrs. Paula S. Zimmer Other name

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
I20080605000432 NY Practitioner - Nurse Practitioner 8022188812 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Ny Doctor of Medicine PLLCGroup PAC ID 8628518750, 28 clinicians

Practice addresses (Care Compare)

427 Guy Park Ave
Amsterdam, NY 12010-1064
Phone (518) 842-1900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.33 of 100Reported as group
Improvement activities
40
Cost
77.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F4300063NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Ny Doctor of Medicine PLLC CurrentSince Jan 1, 2025 Accepting new patients
Atlantic Professional Services of Rhode Island Incorporated CurrentSince Mar 1, 2022 Accepting new patients
Wajeeh Sana Physician PC CurrentSince Mar 11, 2024 Accepting new patients

Locations

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

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.

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1700816568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CRAWFORD DR",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192740",
            "telephone_number": "518-384-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK ST",
            "address_2": "HOSPITALIST PROGRAM",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-5918",
            "fax_number": "518-926-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "PAULA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F4300063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02968032",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "ZIMMER",
            "middle_name": "S.",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.