MEDICARE: ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM1300X	Multi-Specialty Clinic/Center
2	363A00000X	Physician Assistant
3	363L00000X	Nurse Practitioner
4	207XS0106X	Orthopaedic Hand Surgery Physician
5	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician
6	207XS0117X	Orthopaedic Surgery of the Spine Physician
7	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1265387088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 14890
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12212-4890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 ROUTE 9
Second Line	:
City	:	HALFMOON
State	:	NY
Zip	:	12065-2421
Country	:	US
Telephone Number	:	518-269-4690
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	GARY TERK
Credential	:
Telephone Number	:	518-525-5634

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	02/27/2026

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