Individual provider Active NPI

Devorah A Wasserman, MD

  • Family Medicine Physician
  • Albany, NY
National Provider Identifier
1710937297
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
221929 Issued in NY
Practice address
180 Washington Avenue Ext
Albany, NY 12203-5347
Phone
(518) 456-7831
Fax
(518) 456-1561
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 221929 NY Primary

Addresses

Primary practice location

180 Washington Avenue Ext
Albany, NY 12203-5347

Mailing address

156 Kennewyck Cir
Slingerlands, NY 12159-9568
Phone (518) 464-0644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221929NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Physician Services, PC PastSince Nov 1, 2007 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8825/brand/4/csg/1/fhir/r4

Organizations & group practices 1

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710937297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 KENNEWYCK CIR",
            "city": "SLINGERLANDS",
            "state": "NY",
            "postal_code": "121599568",
            "telephone_number": "518-464-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WASHINGTON AVENUE EXT",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035347",
            "telephone_number": "518-456-7831",
            "fax_number": "518-456-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "DEVORAH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "221929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.