NPIMap

Individual provider Active NPI

William S Douglas, DO

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Schenectady, NY
National Provider Identifier
1881049153
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
303083 Issued in NY
Practice address
1270 Belmont Ave
Schenectady, NY 12308-2104
Phone
(518) 382-4560
Fax
(518) 386-3619
NPI assigned
Apr 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 303083 NY Primary

Addresses

Primary practice location

1270 Belmont Ave
Schenectady, NY 12308-2104

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

1182 Troy Schenectady Rd Ste 100
Latham, NY 12110-1000
Phone (518) 713-5400

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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210730000630 NY Practitioner - Physical Medicine and Rehabilitation 2769728476 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sunnyview Hospital and Rehabilitation CenterGroup PAC ID 5496743072, 31 clinicians

Practice addresses (Care Compare)

1182 Troy Schenectady Rd
Suite 100
Latham, NY 12110-1000
Phone (518) 713-5400

1270 Belmont Ave
Schenectady, NY 12308-2104
Phone (518) 382-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
303083NYMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany CurrentSince Dec 1, 2021 Accepting new patients
Sunnyview Hospital and Rehabilitation Center CurrentSince Sep 20, 2021 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Dec 1, 2021 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

1182 Troy Schenectady Rd
Ste 100
Latham, NY 12110
Phone (518) 269-4690

1270 Belmont Ave
Schenectady, NY 12308
Phone (518) 382-4500

Interoperability endpoints

  • Direct secure messaging: wdouglas1330323@direct.trinity-health.org

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 9

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": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1881049153",
    "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",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 BELMONT AVE",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123082104",
            "telephone_number": "518-382-4560",
            "fax_number": "518-386-3619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1182 Troy Schenectady Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Latham",
            "state": "NY",
            "postal_code": "121101000",
            "country_code": "US",
            "telephone_number": "518-713-5400",
            "fax_number": "518-713-5401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "303083",
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "1270 Belmont Ave",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123082104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.