Individual provider Active NPI

Donald Bentrovato, MD

  • Urology Physician
  • Latham, NY
National Provider Identifier
1013947076
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
125931 Issued in NY
Practice address
713 Troy Schenectady Rd
Suite 124
Latham, NY 12110-2490
Phone
(518) 262-3341
Fax
(518) 262-6660
NPI assigned
Jul 4, 2006
Last updated
Feb 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 125931 NY Primary

Addresses

Primary practice location

713 Troy Schenectady Rd
Suite 124
Latham, NY 12110-2490

Mailing address

711 Troy Schenectady Rd
Suite 203
Latham, NY 12110-2442
Phone (518) 782-3700

Other identifiers 1

IdentifierTypeStateIssuer
00922927MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171222000989 NY Order and Referring Only - UrologyPractitioner - Urology 4183625338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125931NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1013947076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 TROY SCHENECTADY RD",
            "address_2": "SUITE 124",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102490",
            "telephone_number": "518-262-3341",
            "fax_number": "518-262-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTROVATO",
        "first_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "125931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00922927",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.