NPIMap

Organization Active NPI

St. Peter's Health Partners Medical Associates, P.C.

  • Pulmonary Disease Physician
  • Troy, NY
National Provider Identifier
1942545777
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Practice address
2 New Hampshire Ave
Troy, NY 12180-1764
Phone
(518) 272-0331
NPI assigned
Dec 5, 2012
Last updated
Oct 7, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCAITES, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Critical Care Medicine (Internal Medicine) Physician 207RC0200X NU
Pulmonary Disease Physician 207RP1001X NU Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X NU

Addresses

Primary practice location

2 New Hampshire Ave
Troy, NY 12180-1764

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

5 Palisades Dr Ste 100
Pulmonary & Critical Care Services
Albany, NY 12205-6433
Phone (518) 438-4496

Other identifiers 1

IdentifierTypeStateIssuer
03539695MedicaidNY

Other names 1

  • Pulmonary & Critical Care Services Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct St. Peter's Health Partners Medical Associates, P.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130321000567 NY Part B Supplier - Clinic/Group Practice 6103061189 Receives reassigned benefits from 869 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Sphpma Crus Urology

Locations

1444 Western Ave
Ste A
Albany, NY 12203
Phone (518) 489-2812

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1942545777",
    "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",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 NEW HAMPSHIRE AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121801764",
            "telephone_number": "518-272-0331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Palisades Dr Ste 100",
            "address_2": "Pulmonary & Critical Care Services",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122056433",
            "country_code": "US",
            "telephone_number": "518-438-4496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCAITES, P.C.",
        "enumeration_date": "2012-12-05",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03539695",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "Y",
            "endpointDescription": "SPHP Payer Credentialing",
            "affiliationName": "St. Peter's Health Partners Medical Associates, P.C.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2 New Hampshire Ave",
            "city": "Troy",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121801764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pulmonary & Critical Care Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.