Active NPI
Andrea Guthorn, FNP
- Nurse Practitioner
- Latham, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- F344809-01
- Practice address
- 1205 Troy Schenectady Rd Ste 101
Latham, NY 12110-1074 - Phone
- (518) 348-3176
- NPI assigned
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F344809-01 | NY | Primary |
Addresses
Primary practice location
1205 Troy Schenectady Rd Ste 101
Latham, NY 12110-1074
Mailing address
7755 Center Ave
Ste 630
Huntington Beach, CA 92647-9152
Phone (657) 400-5180
Other names 1
- Andrea Myrick
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200415000390 | NY | Practitioner - Nurse Practitioner | 9537599659 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arcadian Medical Health PCGenesis Medical Health PC
Practice addresses (Care Compare)
152 Upper Sherman Ave
Queensbury, NY 12804-2746
Phone (845) 354-1212
Hospital & facility affiliations
- Glens Falls Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F344809-01 | NY | MD | Nurse Practitioner |
Practice roles (2 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arcadian Medical Health PC | Current | Accepting new patients | |
| Genesis Medical Health PC | Current | Accepting new patients |
Locations
52 Grove St
Amsterdam, NY 12010
Phone (518) 842-7813
33 Downtown Dr
Fl 3
Monsey, NY 10952
Phone (201) 357-1520
152 Upper Sherman Ave
Queensbury, NY 12804
Phone (518) 581-7260
42 Gurney Ln
Queensbury, NY 12804
Phone (518) 496-2793
116 Martin Luther King E
Syracuse, NY 13205
Phone (315) 475-1641
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Interoperability endpoints
- aguthorn@landmarkhealth-direct.org
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": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574640000000",
"number": "1982240339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7755 CENTER AVE",
"address_2": "STE 630",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926479152",
"telephone_number": "657-400-5180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 TROY SCHENECTADY RD STE 101",
"city": "LATHAM",
"state": "NY",
"postal_code": "121101074",
"telephone_number": "518-348-3176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTHORN",
"first_name": "ANDREA",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2019-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "F344809-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "MYRICK",
"credential": "FNP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.