Individual provider Active NPI

Jacqueline Weaver, MD

  • Emergency Medicine Physician
  • Troy, NY
National Provider Identifier
1902946890
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
237968 Issued in NY
Practice address
2215 Burdett Ave
Troy, NY 12180-2466
Phone
(330) 493-4443
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 237968 NY Primary

Addresses

Primary practice location

2215 Burdett Ave
Troy, NY 12180-2466

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Other identifiers 1

IdentifierTypeStateIssuer
02705879MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051222000679 NY Practitioner - Emergency Medicine 8022030691 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Maryland School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

115 Saratoga Rd
Suite 110
Glenville, NY 12302-4210
Phone (518) 264-2900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237968NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Emergency Medicine CurrentSince Jul 14, 2014 Accepting new patients
Albany Medical College Emergency Medicine CurrentSince Jul 14, 2014 Accepting new patients
Emergency Medicine Association of Pittsburgh Emergency Medicine Past Accepting new patients
Albany Medical College Past Accepting new patients

Locations

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

1019 New Loudon Rd
Cohoes, NY 12047
Phone (518) 262-7500

329 Glenmont Rd
Glenmont, NY 12077
Phone (518) 264-4603

5 New Karner Rd
Guilderland, NY 12084
Phone (518) 869-8007

2976 Route 9W
Saugerties, NY 12477
Phone (518) 264-9400

1400 Altamont Ave
Schenectady, NY 12303
Phone (518) 356-1131

115 Saratoga Rd
Ste 110
Schenectady, NY 12302
Phone (518) 264-2900

730 Hoosick Rd
Troy, NY 12180
Phone (518) 264-3200

11835 Route 9W
West Coxsackie, NY 12192
Phone (518) 731-9000

Interoperability endpoints

  • Direct secure messaging: jweaver20983@albanymed.direct-ci.com

Organizations & group practices 4

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 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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902946890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BURDETT AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121802466",
            "telephone_number": "330-493-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JACQUELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "237968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02705879",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.