NPIMap

Organization Active NPI

Albany General Hosptial

Doing business as Samaritan Urology Albany

  • Urology Physician
  • Albany, OR
National Provider Identifier
1861755902
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ALBANY GENERAL HOSPTIAL
Doing business as
Samaritan Urology Albany
Practice address
400 Hickory St NW Ste 200
Albany, OR 97321-1700
Phone
(541) 812-5800
NPI assigned
Jun 22, 2012
Last updated
May 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Authorized official

Name
David Triebes
Title
Ceo
Phone
(541) 812-4102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

400 Hickory St NW Ste 200
Albany, OR 97321-1700

Mailing address

400 Hickory St NW Ste 200
Albany, OR 97321-1700
Phone (541) 812-5800

Other identifiers 1

IdentifierTypeStateIssuer
5500651934MedicaidOR

Other names 1

  • Samaritan Urology Albany Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000310 OR Part B Supplier - Clinic/Group Practice 9931097987 Receives reassigned benefits from 473 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, OR

Other NPIs on the same Medicare enrollment 31

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

View all 31

National Provider Directory

National Provider Directory
Tax ID family
James L Erickson31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525219200000",
    "number": "1861755902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HICKORY ST NW STE 200",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211700",
            "telephone_number": "541-812-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HICKORY ST NW STE 200",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211700",
            "telephone_number": "541-812-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBANY GENERAL HOSPTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-22",
        "last_updated": "2018-05-02",
        "status": "A",
        "authorized_official_last_name": "TRIEBES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-812-4102"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5500651934",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Urology Albany",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; 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.