Individual provider Active NPI

Mary Kathryn Gleason, NP

  • Pediatric Nurse Practitioner
  • Albany, NY
National Provider Identifier
1700875945
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
380537-1 Issued in NY
Practice address
47 New Scotland Ave
Albany, NY 12208-3412
Phone
(518) 262-5723
Fax
(518) 262-4974
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 380537-1 NY Primary

Addresses

Primary practice location

47 New Scotland Ave
Albany, NY 12208-3412

Mailing address

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5723

Other identifiers 1

IdentifierTypeStateIssuer
01965264MedicaidNY

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
I20101005000944 NY Practitioner - Nurse Practitioner 7012109333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

22 New Scotland Ave
Albany, NY 12208-3795
Phone (518) 262-5723

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
380537-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Jul 11, 2010 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Jul 11, 2010 Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients

Locations

22 New Scotland Ave
#4
Albany, NY 12208

47 New Scotland Ave
#139
Albany, NY 12208
Phone (518) 262-3773

22 New Scotland Ave
Albany, NY 12208
Phone (518) 262-5333

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

Organizations & group practices 5

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1700875945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-5723",
            "fax_number": "518-262-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-5723",
            "fax_number": "518-262-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "380537-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01965264",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.