NPIMap

Organization Active NPI

St. Peter's Hospital of the City of Albany

  • Obstetrics & Gynecology Physician
  • Slingerlands, NY
National Provider Identifier
1861563116
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ST. PETER'S HOSPITAL OF THE CITY OF ALBANY
Practice address
1240 New Scotland Road Suite 100
Slingerlands, NY 12159-9276
Phone
(518) 475-7000
NPI assigned
Nov 10, 2006
Organization subpart
Yes
Parent organization
ST. PETER'S HOSPITAL OF THE CITY OF ALBANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Courtney Knowles
Title
Credentialing Manager
Phone
(518) 525-5634

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 176B00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Multi-Specialty Clinic/Center 261QM1300X
General Acute Care Hospital 282N00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Women's Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LW0102X

Addresses

Primary practice location

1240 New Scotland Road Suite 100
Slingerlands, NY 12159-9276

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other identifiers 1

IdentifierTypeStateIssuer
02333773MedicaidNY

Other names 2

  • SPH Slingerlands OB GYN Other name
  • St. Peter's OB/GYN Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct St. Peter's Hospital of the City of Albany

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040504001301 NY Part B Supplier - Clinic/Group Practice 2668460072 Receives reassigned benefits from 742 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rensselaer, NY; Slingerlands, NY; Schenectady, NY; Saratoga Springs, NY; Latham, NY; Guilderland, NY; Albany, NY; Cohoes, NY

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Robert W Kelty

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1861563116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 NEW SCOTLAND ROAD SUITE 100",
            "city": "SLINGERLANDS",
            "state": "NY",
            "postal_code": "121599276",
            "telephone_number": "518-475-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETER'S HOSPITAL OF THE CITY OF ALBANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. PETER'S HOSPITAL OF THE CITY OF ALBANY",
        "enumeration_date": "2006-11-10",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-525-5634"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02333773",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "Y",
            "endpointDescription": "SPHP Payer Credentialing",
            "affiliationName": "St. Peter's Hospital of the City of Albany",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1240 New Scotland Road Suite 100",
            "city": "Slingerlands",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121599276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SPH Slingerlands OB GYN",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "St. Peter's OB/GYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Slingerlands, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.