Individual provider Active NPI

Isadora Park, PA-C

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1922772508
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
02693201 Issued in NY
Practice address
98 Wolf Rd Ste 16
Albany, NY 12205-1226
Phone
(518) 264-9000
NPI assigned
Aug 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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 02693201 NY Primary

Addresses

Primary practice location

98 Wolf Rd Ste 16
Albany, NY 12205-1226

Mailing address

136 Van Schoick Ave
Albany, NY 12209-1126
Phone (607) 483-3018

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
I20210916001756 NY Practitioner - Physician Assistant 1658778709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
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

11835 RT
9W
West Coxsackie, NY 12192-3605
Phone (518) 264-4600

1400 Altamont Ave
Schenectady, NY 12303-2909
Phone (518) 264-4600

1769 Union St
Niskayuna, NY 12309-6311
Phone (518) 264-4733

329 Glenmont Rd
Glenmont, NY 12077-3469
Phone (518) 264-4603

5 New Karner Rd
Guilderland, NY 12084-9112
Phone (518) 264-4600

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
02693201NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Sep 13, 2021 Accepting new patients
Albany Medical College CurrentSince Sep 13, 2021 Accepting new patients
Albany Medical College CurrentSince Sep 13, 2021 Accepting new patients
Albany Medical College Physician Assistant Past Accepting new patients

Locations

98 Wolf Rd
Ste 16
Albany, NY 12205
Phone (518) 264-9500

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

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

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

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

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

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 and National Provider Directory roles.

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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1922772508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 VAN SCHOICK AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122091126",
            "telephone_number": "607-483-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 WOLF RD STE 16",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051226",
            "telephone_number": "518-264-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ISADORA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "02693201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.