NPIMap

Individual provider Active NPI

Laura Marie Boland, RPA-C

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1912135245
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013318 Issued in NY
Practice address
1365 Washington Ave
Suite 300
Albany, NY 12206-1068
Phone
(518) 489-4704
Fax
(518) 489-0512
NPI assigned
Jun 25, 2009
Last updated
May 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2016

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 013318 NY Primary

Addresses

Primary practice location

1365 Washington Ave
Suite 300
Albany, NY 12206-1068

Mailing address

1365 Washington Ave
Suite 300
Albany, NY 12206-1068
Phone (518) 489-4704

Other identifiers 1

IdentifierTypeStateIssuer
03398592MedicaidNY

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
I20090717000145 NY Practitioner - Physician Assistant 2466504808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

220 Washington Ave Ext
Albany, NY 12203-5316
Phone (518) 262-9600

43 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-3277

47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-5633

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013318NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Apr 1, 2014 Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Albany Medical College CurrentSince Apr 1, 2014 Accepting new patients
Albany Medical College Physician Assistant Past Accepting new patients

Locations

1365 Washington Ave
Ste 300
Albany, NY 12206
Phone (518) 489-4704

220 Washington Avenue Ext
Albany, NY 12203
Phone (518) 264-4453

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

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 6

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1912135245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 WASHINGTON AVE",
            "address_2": "SUITE 300",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061068",
            "telephone_number": "518-489-4704",
            "fax_number": "518-489-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 WASHINGTON AVE",
            "address_2": "SUITE 300",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061068",
            "telephone_number": "518-489-4704",
            "fax_number": "518-489-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03398592",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.