Corey E Ennis, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1184 State Route 50
Ballston Lake, NY 12019-1923

Phone

(518) 384-1281

Fax

(518) 384-0321

NPI assigned

Apr 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ellis Hospital Hospital, Schenectady, NY, CCN 330153

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: coreyennis@ccp.allscriptsdirect.net

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.

• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370
  Medicare reassignment Care Compare group
• Albany Medical College

  • Urgent Care Clinic/Center
  • West Coxsackie, NY
  • NPI 1366872244
  Medicare reassignment NPD
• Albany Medical College

  • Urgent Care Clinic/Center
  • Mechanicville, NY
  • NPI 1346791324
  NPD
• Albany Medical College

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Community Care Physicians, PLLC

  • Family Medicine Physician
  • Ballston Spa, NY
  • NPI 1548541246
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1912392192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 STATE ROUTE 50",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120191923",
            "telephone_number": "518-384-1281",
            "fax_number": "518-384-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "COREY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Albert Demartino, PSY.D.
• Jenna Elizabeth Desbiens, FNP-BC
• Alicia Marie Desmarais, PHARM. D.
• Kristin Doty, LMT
• Jennifer Doud, MS, RD, CDN
• Irwin Bruce Finch, DDS PC
• Yolanda Fleurantin, NP
• Linda Carolyn Fragale
• Jill Frament, PHARMD
• Wilma Frederick, LMHC

• Physician Assistant in Ballston Lake, NY
• Providers in Ballston Lake, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.