Individual provider Active NPI

Madeline Rose Amedore, FNP-BC

  • Family Nurse Practitioner
  • Castleton, NY
National Provider Identifier
1952148017
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F354604 Issued in NY
Practice address
35 Empire State Blvd
Castleton, NY 12033-9777
Phone
(518) 477-2167
Fax
(518) 477-5182
NPI assigned
Jul 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F354604 NY Primary

Addresses

Primary practice location

35 Empire State Blvd
Castleton, NY 12033-9777

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

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
I20240726002902 NY Practitioner - Nurse Practitioner 9234675182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

35 Empire State Blvd
Castleton, NY 12033-9777
Phone (518) 477-2167

Hospital & facility affiliations

  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F354604NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC CurrentSince Aug 19, 2024 Accepting new patients
Community Care Physicians, PC Past Accepting new patients

Locations

35 Empire State Blvd
Castleton on Hudson, NY 12033
Phone (518) 477-2167

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

Interoperability endpoints

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

Organizations & group practices 2

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 1

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": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1952148017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "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": "35 EMPIRE STATE BLVD",
            "city": "CASTLETON",
            "state": "NY",
            "postal_code": "120339777",
            "telephone_number": "518-477-2167",
            "fax_number": "518-477-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMEDORE",
        "first_name": "MADELINE",
        "middle_name": "ROSE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F354604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castleton, NY

Sources for this page

Verify at the official NPI Registry.