Heather Johanson, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

288192 Issued in NY

Practice address

315 S Manning Blvd
Albany, NY 12208-1707

Phone

(518) 525-1550

NPI assigned

Apr 14, 2014

Last updated

May 28, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Heather Lydecker Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians

St Peters Hospital of the City of AlbanyGroup PAC ID 2668460072, 268 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Peter's Hospital Hospital, Albany, NY, CCN 330057
• Sunnyview Hospital and Rehabilitation Center Hospital, Schenectady, NY, CCN 330406
• Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hlydecker788665@direct.trinity-health.org

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.

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• St. Peter's Hospital of the City of Albany

  dba St. Peter's Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106

  Internal Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Samaritan Hospital of Troy, New York

  • General Acute Care Hospital
  • Troy, NY
  • NPI 1043267727
  Care Compare affiliation
• St. Peter's Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation
• Sunnyview Hospital and Rehabilitation Center

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1578664470
  Care Compare affiliation

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1992124440",
    "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",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-525-8600",
            "fax_number": "518-271-3440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47 New Scotland Ave",
            "address_2": "Department of Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-3095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANSON",
        "first_name": "HEATHER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "442507531",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "288192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "LYDECKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• JK Physical Therapy of Albany, PLLC
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• Joel M. Spiro, M.D., P.C.
• Joel Moses MD PLLC
• Joyce Marie Johansson, RN
• Amritpal Singh Johar, DMD
• John B Garrett Inc
• John V Murphy Physical Therapy, PC (Core Physical Therapy)
• John W Repsher PT, LLC

• Internal Medicine Physician in Albany, NY
• Providers in Albany, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.

Verify at the official NPI Registry.