NPIMap

Organization Active NPI

Samaritan Hospital of Troy, New York

  • Family Medicine Physician
  • Stillwater, NY
National Provider Identifier
1912480971
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAMARITAN HOSPITAL OF TROY, NEW YORK
Practice address
1111 Hudson Avenue
Stillwater, NY 12170-3439
Phone
(518) 664-3242
NPI assigned
Sep 14, 2018
Organization subpart
Yes
Parent organization
SAMARITAN HOSPITAL OF TROY, NEW YORKAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Courtney Knowles
Title
Credentialing Manager
Phone
(518) 525-5634

National Provider Directory

National Provider Directory
Tax ID family
Samaritan Hospital-Crna27 organizations share this tax ID, including this one
Part of
Samaritan Hospital-Crna

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

1111 Hudson Ave
Stillwater, NY 12170
Phone (518) 664-3242

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Multi-Specialty Clinic/Center 261QM1300X
General Acute Care Hospital 282N00000X

Addresses

NPPES NPI Registry

Primary practice location

1111 Hudson Avenue
Stillwater, NY 12170-3439

Mailing address

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

Other names 1

NPPES NPI Registry
  • Stillwater Family Health Center Other name

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct Samaritan Hospital of Troy, New York

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 7, 2022.

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1912480971",
    "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": "1111 HUDSON AVENUE",
            "city": "STILLWATER",
            "state": "NY",
            "postal_code": "121703439",
            "telephone_number": "518-664-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN HOSPITAL OF TROY, NEW YORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMARITAN HOSPITAL OF TROY, NEW YORK",
        "enumeration_date": "2018-09-14",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "KNOWLES",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "518-525-5634"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "Y",
            "endpointDescription": "SPHP Payer Credentialing",
            "affiliationName": "Samaritan Hospital of Troy, New York",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1111 Hudson Avenue",
            "city": "Stillwater",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121703439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Stillwater Family Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stillwater, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.