Individual provider Active NPI

Alida M King, FNP

  • Family Nurse Practitioner
  • Queensbury, NY
National Provider Identifier
1902379688
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345975 Issued in NY
Practice address
161 Carey Rd
Queensbury, NY 12804-7821
Phone
(518) 824-8610
Fax
(518) 824-2390
NPI assigned
Jan 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 345975 NY Primary

Addresses

Primary practice location

161 Carey Rd
Queensbury, NY 12804-7821

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other identifiers 1

IdentifierTypeStateIssuer
05439267MedicaidNY

Other names 1

  • Alida M Breault Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alida.king.1@1823.direct.athenahealth.com

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
I20201222002935 NY Practitioner - Nurse Practitioner 0244642940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Headwaters Health NetworkGroup PAC ID 7416861208, 221 clinicians

Practice addresses (Care Compare)

161 Carey Rd
Queensbury, NY 12804-7821
Phone (518) 824-8610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
345975NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Headwaters Health Network CurrentSince Jan 18, 2021 Accepting new patients
Hudson Headwaters Health Network CurrentSince Jan 18, 2021 Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients

Locations

100 Broad St
Glens Falls, NY 12801
Phone (518) 792-2223

161 Carey Rd
Queensbury, NY 12804
Phone (518) 480-0011

9 Carey Rd
Queensbury, NY 12804

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": "1546732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1902379688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047821",
            "telephone_number": "518-824-8610",
            "fax_number": "518-824-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ALIDA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-06",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05439267",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alida.king.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "161 Carey Rd",
            "city": "Queensbury",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128047821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALIDA",
            "last_name": "BREAULT",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Queensbury, NY

Sources for this page

Verify at the official NPI Registry.