Individual provider Active NPI

Kerstin Lorelei Rieg, PA-C

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1972371508
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
326 S Pearl St
Albany, NY 12202-1914
Phone
(518) 449-0100
Fax
(518) 463-8580
NPI assigned
Dec 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601012076 MI
Physician Assistant 363A00000X NY Primary

Addresses

Primary practice location

326 S Pearl St
Albany, NY 12202-1914

Mailing address

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Other practice location 1

829 N Center Ave Ste 130
Gaylord, MI 49735-1684
Phone (989) 731-7930

Other practice location 2

825 N Center Ave
Gaylord, MI 49735-1592
Phone (989) 731-7996

Other practice location 3

1100 E Michigan Ave
Grayling, MI 49738-1312
Phone (989) 348-5461

Other practice location 4

1250 E Michigan Ave Ste C
Grayling, MI 49738-7074
Phone (989) 348-0550

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240130001386 MI Practitioner - Physician Assistant 6305299025 Reassigns benefits to 2 organizations
I20240927002224 NY Practitioner - Physician Assistant 6305299025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Peters Hospital of the City of AlbanyGroup PAC ID 2668460072, 268 clinicians

Practice addresses (Care Compare)

315 S Manning Blvd
Albany, NY 12208-1707

326 S Pearl St
Albany, NY 12202-1914
Phone (518) 449-0100

Hospital & facility affiliations

  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057
  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601012076MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Grayling CurrentSince Jan 25, 2024 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Jan 25, 2024 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Jan 25, 2024 Accepting new patients
St. Peter'S Hospital of the City of Albany Physician Assistant CurrentSince Sep 30, 2024 Accepting new patients
St. Peter'S Hospital of the City of Albany Physician Assistant CurrentSince Sep 30, 2024 Accepting new patients
St. Peter'S Hospitalof the City of Albany Physician Assistant Past Accepting new patients

Locations

3781 Momentum Pl
Chicago, IL 60689

829 N Center Ave
Ste 130
Gaylord, MI 49735
Phone (989) 731-7930

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

1250 E Michigan Ave
Ste C
Grayling, MI 49738
Phone (989) 348-0550

1250 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0550

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

326 S Pearl St
Albany, NY 12202
Phone (518) 449-0100

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

Interoperability endpoints

  • Direct secure messaging: krieg3579383@direct.trinity-health.org

Organizations & group practices 7

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 2

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": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1972371508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 S PEARL ST",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122021914",
            "telephone_number": "518-449-0100",
            "fax_number": "518-463-8580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 N Center Ave Ste 130",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351684",
            "country_code": "US",
            "telephone_number": "989-731-7930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 N Center Ave",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351592",
            "country_code": "US",
            "telephone_number": "989-731-7996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497381312",
            "country_code": "US",
            "telephone_number": "989-348-5461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 E Michigan Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497387074",
            "country_code": "US",
            "telephone_number": "989-348-0550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIEG",
        "first_name": "KERSTIN",
        "middle_name": "LORELEI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012076",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "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": "326 S Pearl St",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122021914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.