Individual provider Active NPI

Julie McCole Phillips, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Albany, NY
National Provider Identifier
1740292788
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
235935 Issued in NY
Practice address
113 Holland Ave
Albany, NY 12208-3410
Phone
(518) 626-6047
NPI assigned
Aug 11, 2006
Last updated
Sep 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 235935 NY Primary

Addresses

Primary practice location

113 Holland Ave
Albany, NY 12208-3410

Mailing address

113 Holland Ave
Albany, NY 12208-3410
Phone (518) 626-6093

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160427000847 NY Order and Referring Only - Internal MedicinePractitioner - Internal MedicinePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 3779514625

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235935NYMDGeriatric Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1740292788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083410",
            "telephone_number": "518-626-6093",
            "fax_number": "518-626-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HOLLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083410",
            "telephone_number": "518-626-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JULIE",
        "middle_name": "MCCOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "235935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.