NPIMap

Individual provider Active NPI

Maria Theodoulou, MD

  • Medical Oncology Physician
  • Albany, NY
National Provider Identifier
1720174055
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
183499 Issued in NY
Practice address
400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5013
Phone
(518) 489-0044
Fax
(518) 489-3591
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 183499 NY Primary

Addresses

Primary practice location

400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5013

Mailing address

400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5013
Phone (518) 489-0044

Other identifiers 1

IdentifierTypeStateIssuer
03577891MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100426000192 NY Practitioner - Medical OncologyPractitioner - Internal Medicine 9739216631 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York Oncology Hematology PCGroup PAC ID 3072406222, 82 clinicians

Practice addresses (Care Compare)

400 Patroon Creek Blvd
Suite 1
Albany, NY 12206-5012
Phone (518) 489-0444

Hospital & facility affiliations

  • Community Hospice, Inc, the Hospice, Albany, NY, CCN 331501
  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013
  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057
  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
  • Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049
  • Columbia Memorial Hospital Hospital, Hudson, NY, CCN 330094

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
183499NYMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Solid Tumor Group Medical Oncology CurrentSince Jan 1, 1990 Accepting new patients
New York Oncology Hematology, P.C. CurrentSince Mar 2, 2016 Accepting new patients
New York Oncology Hematology PC CurrentSince Mar 2, 2016 Accepting new patients

Locations

400 Patroon Creek Blvd
Ste 210
Albany, NY 12206
Phone (518) 459-8106

400 Patroon Creek Blvd
Ste 1
Albany, NY 12206
Phone (518) 399-4600

1700 Riverfront Ctr
Amsterdam, NY 12010
Phone (518) 483-0020

69 Prospect Ave
Hudson, NY 12534
Phone (212) 459-8173

69 Prospect Ave
Ste C
Hudson, NY 12534

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

896 Riverview Rd
Rexford, NY 12148
Phone (518) 399-4600

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 10

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1720174055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PATROON CREEK BLVD",
            "address_2": "SUITE 1",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122065013",
            "telephone_number": "518-489-0044",
            "fax_number": "518-489-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PATROON CREEK BLVD",
            "address_2": "SUITE 1",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122065013",
            "telephone_number": "518-489-0044",
            "fax_number": "518-489-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOULOU",
        "first_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NY",
            "license": "183499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03577891",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.