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MARYBETH BOSSOLINI
NPI 1871908335
Nurse Practitioner - Family in Troy, NY

Active since June 24, 2014PECOS Enrolled
101 JORDAN RD, SUITE 200, TROY, NY 12180(518) 274-0476(518) 274-0497 Get Directions Write a Review

NPPES record last updated: March 22, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 22, 2016, Jan 25, 2016 (2 updates tracked since 2016).

About Marybeth Bossolini NPPES

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

MARYBETH BOSSOLINI (NPI 1871908335) is an individual family provider in Troy, New York, licensed in New York (338889) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS, is affiliated with St Peter's Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1871908335
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARYBETH BOSSOLINI
Location Address101 JORDAN RD, SUITE 200Troy, NY 12180-8309
Mailing Address711 Troy Schenectady Rd, Suite 203Latham, NY 12110-2442 · (518) 782-3700 · Fax (518) 782-3799
Phone(518) 274-0476
Fax(518) 274-0497
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJune 24, 2014
Last NPPES UpdateMarch 22, 20162 updates tracked since enumeration
✔ NPI 1871908335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 338889
101 JORDAN RD, Troy, NY 12180
Open in Google Maps ↗

Other Identifiers 1

Medicare PINJ400283099NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marybeth Bossolini is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2062631880
PECOS Enrollment IDI20140910000116
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Marybeth Bossolini reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rensselaer County Bureau Of Finance
1.1 mi
Skilled Nursing Facility
85 BLOOMINGROVE DR
Troy, NY 12180
  • Reassigned Medicare billing, New York enrollment
  • 13 clinicians in this Medicare group
NPI 1225273485 (518) 283-2000
St. Peter's Health Partners Medical Associates, P.C.
2.9 mi
Urology
63 SHAKER RD STE 202, CAPITAL REGION UROLOGY
Albany, NY 12204
  • Reassigned Medicare billing, New York enrollment
  • 742 clinicians in this Medicare group
NPI 1285061721 (518) 434-1283
W Bruce Clark MD PC
4.9 mi
Obstetrics & Gynecology
585 NEW LOUDON RD
Latham, NY 12110
  • Reassigned Medicare billing, New York enrollment
  • 17 clinicians in this Medicare group
NPI 1396959110 (518) 783-1472

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Peter's Hospital

Acute Care Hospitals · Albany, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330057
Location315 South Manning BoulevardAlbany, NY 12208 · Albany County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12180 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. ADRIAN PRZYBYLA M.D.
Plastic Surgery
101 JORDAN RD, SUITE 103
TROY, NY 12180
Rensselaer County (518) 274-6829
DONALD JUE
Internal Medicine
101 JORDAN RD, SUITE 101
TROY, NY 12180
Rensselaer County (518) 274-9126
COMMUNITY CARE PHYSICIANS, PC
Obstetrics & Gynecology
101 JORDAN RD, SUITE 200
TROY, NY 12180
Rensselaer County (518) 274-0476
DR. RACHELLE BRILLIANT DO
Family Medicine
101 JORDAN RD, SUITE 104
TROY, NY 12180
Rensselaer County (518) 274-9126
ERIC GROSS MD
Internal Medicine
101 JORDAN RD, SUITE 100
TROY, NY 12180
Rensselaer County (518) 274-9126
DR. JENNIFER M WILEY M.D.
Family Medicine
101 JORDAN RD, SUITE 104
TROY, NY 12180
Rensselaer County (518) 274-0024
COMMUNITY CARE PHYSICIANS, PC
Internal Medicine
101 JORDAN RD, SUITE 100
TROY, NY 12180
Rensselaer County (518) 274-9126
DR. MARY SUSAN ELACQUA M.D.
Obstetrics & Gynecology (Gynecology)
101 JORDAN RD, SUITE 200
TROY, NY 12180
Rensselaer County (518) 274-0476

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 Marybeth Bossolini's NPI number?

The NPI number for Marybeth Bossolini is 1871908335. It was assigned to this individual provider in the NPPES registry on June 24, 2014.

Where is Marybeth Bossolini located?

Marybeth Bossolini practices at 101 Jordan Rd Suite 200, Troy, NY 12180. The listed phone number is (518) 274-0476.

What is Marybeth Bossolini's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Marybeth Bossolini enrolled in Medicare?

Yes. Marybeth Bossolini is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Marybeth Bossolini's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marybeth Bossolini reassigns Medicare benefits to 3 organizations: Rensselaer County Bureau Of Finance (Troy, NY), St. Peter's Health Partners Medical Associates, P.C. (Albany, NY) and W Bruce Clark MD PC (Latham, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marybeth Bossolini's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Marybeth Bossolini affiliated with any hospitals?

According to CMS data, Marybeth Bossolini is affiliated with St Peter's Hospital.

When was this NPI record last updated?

The NPPES record for Marybeth Bossolini was last updated on March 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.