NPIMap

Organization Active NPI

Ellis Hospital

  • Family Medicine Physician
  • Schenectady, NY
National Provider Identifier
1760614317
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ELLIS HOSPITAL
Practice address
1101 Nott St
Schenectady, NY 12308
Phone
(518) 243-4000
NPI assigned
Aug 17, 2009
Organization subpart
Yes
Parent organization
ELLIS HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Authorized official

Name
Paul A Milton
Title
President & Ceo
Phone
(518) 243-4141

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 4601001H NY
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 4601001H NY
Neonatal-Perinatal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080N0001X 4601001H NY
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 4601001H NY
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 4601001H NY
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X 4601001H NY

Addresses

Primary practice location

1101 Nott St
Schenectady, NY 12308

Mailing address

600 McClellan St
2 West
Schenectady, NY 12304-1009
Phone (518) 347-5400

Other identifiers 1

IdentifierTypeStateIssuer
03177066MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Edward W Doucet MD37 organizations share this tax ID, including this one
Part of
Edward W Doucet MD

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

600 McClellan St
#2W
Schenectady, NY 12304

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1760614317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MCCLELLAN ST",
            "address_2": "2 WEST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123041009",
            "telephone_number": "518-347-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NOTT ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "12308",
            "telephone_number": "518-243-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIS HOSPITAL",
        "enumeration_date": "2009-08-17",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "MILTON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "518-243-4141"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "4601001H",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "4601001H",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "4601001H",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "4601001H",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "4601001H",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "4601001H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03177066",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.