NPIMap

Individual provider Active NPI

Amy Elizabeth Hogan-Moulton, MD

  • Nephrology Physician
  • Glens Falls, NY
National Provider Identifier
1730177825
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
210381 Issued in NY
Practice address
2 Broad Street PLZ
Broad Street Medical Group
Glens Falls, NY 12801-4363
Phone
(518) 926-1770
Fax
(518) 926-1799
NPI assigned
Oct 12, 2005
Last updated
Jun 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 210381 NY Primary
Internal Medicine Physician 207R00000X 210381 NY

Addresses

Primary practice location

2 Broad Street PLZ
Broad Street Medical Group
Glens Falls, NY 12801-4363

Mailing address

PO Box 304
Glens Falls, NY 12801-0304
Phone (518) 926-1770

Other identifiers 2

IdentifierTypeStateIssuer
390006064OtherNYRR MEDICARE
01824359MedicaidNY

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
I20050815000213 NY Practitioner - Nephrology 3072543610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Albany Medical College of Union University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians
Saratoga Regional Medical , P.CGroup PAC ID 9032438544, 23 clinicians

Practice addresses (Care Compare)

3050 Route 50
Saratoga Springs, NY 12866-2958
Phone (518) 886-5100

59 Myrtle St
Saratoga Springs, NY 12866-1027
Phone (518) 587-2400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
68.51 of 100Reported as group
Quality
56.19
Improvement activities
40
Cost
75.36

Merit-based Incentive Payment System (MIPS)

Final score
82.54 of 100Reported as group
Quality
71.72
Improvement activities
40
Cost
73.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210381NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital CurrentSince Sep 1, 2012 Accepting new patients
Saratoga Hospital Internal Medicine CurrentSince Sep 1, 2012 Accepting new patients
Saratoga Regional Medical , P.C CurrentSince Jul 8, 2019 Accepting new patients
Saratoga Regional Medical , P.C Nephrology CurrentSince Jul 8, 2019 Accepting new patients
Saratoga Hospital Past Accepting new patients

Locations

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

2 Broad Street Plz
Glens Falls, NY 12801
Phone (518) 793-0519

2911 State Route 9
Ste 1
Malta, NY 12020
Phone (518) 363-8815

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

3050 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5108

59C Myrtle St
Saratoga Springs, NY 12866
Phone (518) 587-1919

6 Care Ln
Saratoga Springs, NY 12866
Phone (518) 587-7625

Interoperability endpoints

  • Direct secure messaging: ahoganmoulton98510@albanymed.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 29

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1730177825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 304",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128010304",
            "telephone_number": "518-926-1770",
            "fax_number": "518-926-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BROAD STREET PLZ",
            "address_2": "BROAD STREET MEDICAL GROUP",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014363",
            "telephone_number": "518-926-1770",
            "fax_number": "518-926-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN-MOULTON",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "210381",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "210381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "390006064",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01824359",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.