NPIMap

Individual provider Active NPI

Kristin N Yannetti, M.D.

  • Family Medicine Physician
  • Rensselaer, NY
National Provider Identifier
1952585945
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
258204-1 Issued in NY
Practice address
279 Troy Rd
Family Medical Group
Rensselaer, NY 12144-9499
Phone
(518) 286-1922
Fax
(518) 283-3225
NPI assigned
Dec 26, 2007
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 258204-1 NY Primary

Addresses

Primary practice location

279 Troy Rd
Family Medical Group
Rensselaer, NY 12144-9499

Mailing address

PO Box 14890
SPHP Payer Credentialing
Albany, NY 12212-4890
Phone (518) 286-1922

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101022001314 NY Practitioner - Family Practice 9133312085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians

Practice addresses (Care Compare)

125 Harry Howard Ave
Hudson, NY 12534-1601
Phone (800) 479-7695

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3554

279 Troy Rd
Rensselaer, NY 12144-9756
Phone (518) 286-1922

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
258204-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York Family Medicine CurrentSince Sep 13, 2010 Accepting new patients
Samaritan Hospital of Troy, New York Past Accepting new patients

Locations

279 Troy Rd
Rensselaer, NY 12144
Phone (518) 286-1922

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: kyannetti150780@direct.trinity-health.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1952585945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "address_2": "SPHP PAYER CREDENTIALING",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-286-1922",
            "fax_number": "518-427-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 TROY RD",
            "address_2": "FAMILY MEDICAL GROUP",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121449499",
            "telephone_number": "518-286-1922",
            "fax_number": "518-283-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANNETTI",
        "first_name": "KRISTIN",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "258204-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "279 Troy Rd",
            "address_2": "Family Medical Group",
            "city": "Rensselaer",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121449499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

Verify at the official NPI Registry.