Individual provider Active NPI

Alexa Suzanne Palmieri, PA-C

  • Surgical Physician Assistant
  • Glens Falls, NY
National Provider Identifier
1861802050
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
017605 Issued in NY
Practice address
14 Hudson Ave
Glens Falls, NY 12801-4448
Phone
(518) 489-2663
NPI assigned
Apr 28, 2014
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 017605 NY Primary
Physician Assistant 363A00000X 017605 NY

Addresses

Primary practice location

14 Hudson Ave
Glens Falls, NY 12801-4448

Mailing address

121 Everett Rd
Albany, NY 12205-1474
Phone (518) 489-2663

Other practice location 1

1184 State Route 50
Ballston Lake, NY 12019-1923
Phone (518) 384-1281

Other practice location 2

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

Other practice location 3

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

Other identifiers 1

IdentifierTypeStateIssuer
04297265MedicaidNY

Other names 1

  • Alexa Suzanne Etkin Former name

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
I20151105000740 NY Practitioner - Physician Assistant 7315257235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Albany Medical College of Union University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedicsny, LLPGroup PAC ID 6901898170, 115 clinicians

Practice addresses (Care Compare)

121 Everett Rd
Albany, NY 12205-1474
Phone (518) 489-2663

14 Hudson Ave
Glens Falls, NY 12801-4448
Phone (518) 689-3856

5 Care LN
Saratoga Springs, NY 12866-8623
Phone (518) 489-2663

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017605NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedicsny, LLP CurrentSince Jun 1, 2025 Accepting new patients
Orthopedicsny, LLP CurrentSince Jun 1, 2025 Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

16 Maxwell Dr
Clifton Park, NY 12065
Phone (518) 557-1800

121 Everett Rd
Colonie, NY 12205

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

6 Medical Park Dr
Malta, NY 12020
Phone (518) 289-2020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1861802050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051474",
            "telephone_number": "518-489-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 HUDSON AVE",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014448",
            "telephone_number": "518-489-2663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1184 State Route 50",
            "address_purpose": "LOCATION",
            "city": "Ballston Lake",
            "state": "NY",
            "postal_code": "120191923",
            "country_code": "US",
            "telephone_number": "518-384-1281",
            "fax_number": "518-384-0321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-271-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMIERI",
        "first_name": "ALEXA",
        "middle_name": "SUZANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "017605",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017605",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04297265",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP 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": [
        {
            "first_name": "ALEXA",
            "last_name": "ETKIN",
            "middle_name": "SUZANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.