Individual provider Active NPI

Alexandra Anne Mazzariello, PA

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1881252708
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023551 Issued in NY
Practice address
2 Palisades Dr
Albany, NY 12205-1438
Phone
(518) 458-2000
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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 023551 NY Primary

Addresses

Primary practice location

2 Palisades Dr
Albany, NY 12205-1438

Mailing address

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

Other practice location 1

156 Quaker Rd
Queensbury, NY 12804-1718
Phone (518) 458-2000

Other practice location 2

1735 Route 9
Halfmoon, NY 12065-2421
Phone (518) 458-2000

Other practice location 3

2 New Hampshire Ave Ste 200
Troy, NY 12180-1762
Phone (518) 458-2000

Other practice location 4

6 Care Ln
Saratoga Springs, NY 12866-8651
Phone (518) 587-7625

Other names 1

  • Alexandra Anne Kohut Other 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
I20190826002832 NY Practitioner - Physician Assistant 2668700832 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

99 E State St
Gloversville, NY 12078-1203
Phone (518) 773-5690

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan Littauer Hospital & Nursing Home CurrentSince Feb 11, 2025 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Physician Assistant CurrentSince Oct 18, 2021 Accepting new patients
Nathan Littauer Hospital Association CurrentSince Feb 11, 2025 Accepting new patients

Locations

2 Palisades Dr
Albany, NY 12205

99 E State St
Gloversville, NY 12078
Phone (518) 773-5690

1735 Route 9
Halfmoon, NY 12065
Phone (518) 269-4690

156 Quaker Rd
Queensbury, NY 12804
Phone (518) 793-9063

6 Care Ln
Saratoga Springs, NY 12866
Phone (518) 581-1415

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

2 New Hampshire Ave
Ste 200
Troy, NY 12180
Phone (518) 274-1947

Interoperability endpoints

  • Direct secure messaging: akohut1364612@direct.trinity-health.org

Organizations & group practices 5

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 5

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1881252708",
    "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": "2 PALISADES DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051438",
            "telephone_number": "518-458-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "156 Quaker Rd",
            "address_purpose": "LOCATION",
            "city": "Queensbury",
            "state": "NY",
            "postal_code": "128041718",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1735 Route 9",
            "address_purpose": "LOCATION",
            "city": "Halfmoon",
            "state": "NY",
            "postal_code": "120652421",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 New Hampshire Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801762",
            "country_code": "US",
            "telephone_number": "518-458-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Care Ln",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128668651",
            "country_code": "US",
            "telephone_number": "518-587-7625",
            "fax_number": "518-587-0273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZZARIELLO",
        "first_name": "ALEXANDRA",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023551",
            "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": "2 Palisades Dr",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122051438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "KOHUT",
            "middle_name": "ANNE",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.