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

NPI Status: Active since January 16, 2012

Contact Information

553 CLINTON AVE
ALBANY, NY
ZIP 12206
Phone: (518) 689-0282
Fax: (518) 689-0283

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  • Organization
  • Clinic/Center
  • CLIA Number: 33D0998757
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 03-26-2027

About KOINONIA PRIMARY CARE INC

This page provides the complete NPI Profile along with additional information for Koinonia Primary Care Inc, a provider established in Albany, New York operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1023389533 assigned on January 2012. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's former legal business name is Koinonia Primary Medical Care Pc. The authorized official of this NPI record is Dr. Robert John Paeglow M.d. (President)

NPI
1023389533
Provider Legal Name
KOINONIA PRIMARY CARE INC
Other Organization Name
KOINONIA PRIMARY MEDICAL CARE PC
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
553 CLINTON AVE ALBANY, NY 12206
Location Phone
(518) 689-0282
Location Fax
(518) 689-0283
Mailing Address
553 CLINTON AVE ALBANY, NY 12206
Mailing Phone
(518) 689-0282
Mailing Fax
(518) 689-0283
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-16-2012
Last Update Date
01-16-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
License State
NY
Taxonomy Description
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).

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ROBERT JOHN PAEGLOW M.D.

Authorized Official Title
PRESIDENT
Authorized Official Phone
(518) 689-0282

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
33D0998757
Facility Type
Community Clinic
Certificate Effective Date
March 27, 2018
Certificate Expiration Date
March 26, 2027
Laboratory Director
DR. ROBERT J. PAEGLOW
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Koinonia Primary Care Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1023389533, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
2
Doubled → 4
Pos 4
3
Unchanged
Pos 5
3
Doubled → 6
Pos 6
8
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
5
Unchanged
Pos 9
3
Doubled → 6
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 3 → 6 9 → 18 → 9 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 4 + 3 + 6 + 8 + 1 + 8 + 5 + 6 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1023389533.

Other Providers at the Same Location


The following 9 providers are registered at the same or a nearby location.

Pediatrics (Developmental - Behavioral Pediatrics)
553 CLINTON AVE, KOINONIA HEALTH CARE
ALBANY, NY 12206
Family Medicine
553 CLINTON AVE
ALBANY, NY 12206
Psychiatry & Neurology (Psychiatry)
553 CLINTON AVE
ALBANY, NY 12206
Clinic/Center (Mental Health (Including Community Mental Health Center))
553 CLINTON AVE
ALBANY, NY 12206
Nurse Practitioner (Family)
553 CLINTON AVE
ALBANY, NY 12206
Nurse Practitioner (Family)
553 CLINTON AVE
ALBANY, NY 12206
Counselor (Mental Health)
553 CLINTON AVE
ALBANY, NY 12206
Nurse Practitioner (Primary Care)
553 CLINTON AVE
ALBANY, NY 12206
Physician Assistant
553 CLINTON AVE
ALBANY, NY 12206

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023389533, enumerated as an "organization" on January 16, 2012.

The provider is located at 553 CLINTON AVE ALBANY, NY 12206 and the phone number is (518) 689-0282.

Clinic/Center with taxonomy code 261Q00000X.