NPIMap

Individual provider Active NPI

Amber Wagg

  • Physician Assistant
  • Potsdam, NY
National Provider Identifier
1861801607
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017608 Issued in NY
Practice address
50 Leroy St
Chemical Dependency Unit
Potsdam, NY 13676-1786
Phone
(315) 244-4017
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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 017608 NY Primary

Addresses

Primary practice location

50 Leroy St
Chemical Dependency Unit
Potsdam, NY 13676-1786

Mailing address

50 Leroy St
Chemical Dependency Unit
Potsdam, NY 13676-1786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141023001328 NY Practitioner - Physician Assistant 3274754841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians

Practice addresses (Care Compare)

3040 Route 50
Saratoga Springs, NY 12866-3073
Phone (518) 580-2273

3044 Route 50
Saratoga Springs, NY 12866-3073
Phone (518) 886-5800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
68.51 of 100Reported as group
Quality
56.19
Improvement activities
40
Cost
75.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017608NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince Jun 1, 2016 Accepting new patients
Saratoga Hospital CurrentSince Jun 1, 2016 Accepting new patients

Locations

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

3050 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5108

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1861801607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "address_2": "CHEMICAL DEPENDENCY UNIT",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "address_2": "CHEMICAL DEPENDENCY UNIT",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-244-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGG",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

Verify at the official NPI Registry.