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KOINONIA PRIMARY CARE INC
NPI 1023389533
Clinic/Center in Albany, NY

Active since January 16, 2012CLIA 33D0998757 · Waiver
553 CLINTON AVE, ALBANY, NY 12206(518) 689-0282(518) 689-0283 Get Directions Write a Review

NPPES record last updated: January 16, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Koinonia Primary Care Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOINONIA PRIMARY CARE INC (NPI 1023389533), doing business as Koinonia Primary Medical Care Pc, is a healthcare organization registered as a clinic/center in Albany, New York and active in the NPI registry since January 2012. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Robert John Paeglow, President, as its authorized official.

NPPES Registry Identity

NPI1023389533
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameKOINONIA PRIMARY CARE INC
Location Address553 CLINTON AVEAlbany, NY 12206-2738
Mailing Address553 Clinton AveAlbany, NY 12206-2738 · (518) 689-0282 · Fax (518) 689-0283
Phone(518) 689-0282
Fax(518) 689-0283
Organization SubpartNo
Authorized OfficialRobert John PaeglowPresident · (518) 689-0282
Enumeration DateJanuary 16, 2012
✔ NPI 1023389533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
553 CLINTON AVE, Albany, NY 12206
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Other Names 1

Former Legal Business NameKoinonia Primary Medical Care Pc

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D0998757

Koinonia Primary Care Inc · Albany, NY
Active · expires Mar 26, 2027
CLIA Number33D0998757
Laboratory TypeCommunity Clinic
Certificate Effective DateMarch 27, 2018
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Robert J. Paeglow
Laboratory Phone(518) 689-0282
Laboratory LocationKoinonia Primary Care Inc553 Clinton Avenue, Albany, NY 12206
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NINA SAPONARA LMHC
Counselor (Mental Health)
553 CLINTON AVE
ALBANY, NY 12206
Albany County (518) 689-0282
ELAINE HO FNP-BC
Nurse Practitioner (Family)
553 CLINTON AVE
ALBANY, NY 12206
Albany County (518) 689-0282
SUSAN M AUSTIN MD PLLC
Psychiatry & Neurology (Psychiatry)
553 CLINTON AVE
ALBANY, NY 12206
Albany County (518) 462-3047
DEBORAH LEADHOLM KRISS M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
553 CLINTON AVE, KOINONIA HEALTH CARE
ALBANY, NY 12206
Albany County (518) 689-0282
DR. ROBERT JOHN PAEGLOW M.D.
Family Medicine
553 CLINTON AVE
ALBANY, NY 12206
Albany County (518) 689-0282
RESURRECTION MINISTRIES
Clinic/Center (Mental Health (Including Community Mental Health Center))
553 CLINTON AVE
ALBANY, NY 12206
Albany County (518) 689-0282
ELIEZER HERNANDEZ
Nurse Practitioner (Primary Care)
553 CLINTON AVE
ALBANY, NY 12206
Albany County (518) 689-0282
MS. CATHLEEN WHITMORE SVENSON FNP
Nurse Practitioner (Family)
553 CLINTON AVE
ALBANY, NY 12206
Albany County (518) 689-0282

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Koinonia Primary Care Inc's NPI number?

The NPI number for Koinonia Primary Care Inc is 1023389533. It was assigned to this organization in the NPPES registry on January 16, 2012. The provider was formerly known as Koinonia Primary Medical Care PC.

Where is Koinonia Primary Care Inc located?

Koinonia Primary Care Inc is located at 553 Clinton Ave, Albany, NY 12206. The listed phone number is (518) 689-0282.

What is Koinonia Primary Care Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Koinonia Primary Care Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0998757) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Koinonia Primary Care Inc was last updated on January 16, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.