Individual provider Active NPI

Tracy Dee Amsden, RPA-C

  • Surgical Physician Assistant
  • Albany, NY
National Provider Identifier
1861509531
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
005019 Issued in NY
Practice address
1365 Washington Ave Ste 300
Albany, NY 12206-1098
Phone
(518) 489-4704
Fax
(518) 489-0512
NPI assigned
Aug 25, 2006
Last updated
Mar 5, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 005019 NY Primary

Addresses

Primary practice location

1365 Washington Ave Ste 300
Albany, NY 12206-1098

Mailing address

1365 Washington Ave
Albany, NY 12206-1068
Phone (518) 489-4704

Other identifiers 1

IdentifierTypeStateIssuer
02916705MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1861509531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 WASHINGTON AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061068",
            "telephone_number": "518-489-4704",
            "fax_number": "518-489-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 WASHINGTON AVE STE 300",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061098",
            "telephone_number": "518-489-4704",
            "fax_number": "518-489-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSDEN",
        "first_name": "TRACY",
        "middle_name": "DEE",
        "name_prefix": "Ms.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "005019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02916705",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.