Individual provider Active NPI

William Seth Hallenbeck III, M.D.

  • Adult Medicine Physician
  • Greene, NY
National Provider Identifier
1063720076
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
087920 Issued in NY
Practice address
248 Race Rd
Greene, NY 13778-4157
Phone
(607) 656-9700
Fax
(607) 656-9700
NPI assigned
Sep 24, 2010
Last updated
Sep 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 087920 NY
Adult Medicine Physician 207QA0505X 087920 NY Primary

Addresses

Primary practice location

248 Race Rd
Greene, NY 13778-4157

Mailing address

248 Race Rd
Greene, NY 13778-4157
Phone (607) 656-9700

Other identifiers 1

IdentifierTypeStateIssuer
00627078MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1063720076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 RACE RD",
            "city": "GREENE",
            "state": "NY",
            "postal_code": "137784157",
            "telephone_number": "607-656-9700",
            "fax_number": "607-656-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 RACE RD",
            "city": "GREENE",
            "state": "NY",
            "postal_code": "137784157",
            "telephone_number": "607-656-9700",
            "fax_number": "607-656-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLENBECK",
        "first_name": "WILLIAM",
        "middle_name": "SETH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-24",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "087920",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NY",
            "license": "087920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00627078",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greene, NY

Sources for this page

Verify at the official NPI Registry.