Individual provider Active NPI

William Michael Kutzer, PA

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1770552507
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006095-1 Issued in NY
Practice address
315 S Manning Blvd
Albany, NY 12208-1707
Phone
(518) 275-4097
Fax
(518) 944-2526
NPI assigned
Mar 15, 2006
Last updated
May 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006095-1 NY Primary

Addresses

Primary practice location

315 S Manning Blvd
Albany, NY 12208-1707

Mailing address

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105000904 NY Practitioner - Physician Assistant 4183687635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 New Hampshire Ave
Troy, NY 12180-1764
Phone (518) 525-8220

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3300

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1852

319 S Manning Blvd
Albany, NY 12208-1743

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006095-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Physician Assistant CurrentSince Aug 28, 2018 Accepting new patients
Albany Medical College CurrentSince Sep 30, 2016 Accepting new patients
Albany Medical College Physician Assistant CurrentSince Sep 30, 2016 Accepting new patients
St. Peter's Health Partners Medical Associates, P.C. Physician Assistant CurrentSince Apr 25, 2017 Accepting new patients
Emergency Medicine Physicians of Albany County, PLLC Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
#139
Albany, NY 12208
Phone (518) 262-3773

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

1301 River St
Ste 204
Valatie, NY 12184
Phone (518) 392-8600

Interoperability endpoints

  • Direct secure messaging: kwilliam150428@direct.trinity-health.org
  • Direct secure messaging: payer.credentialing@sphp.com
  • Direct secure messaging: wkutzer26309@albanymed.direct-ci.com

Organizations & group practices 5

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 2

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1770552507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-275-4097",
            "fax_number": "518-944-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTZER",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006095-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.