Individual provider Active NPI

Benjamin James Infantino, MD

  • Pediatric Gastroenterology Physician
  • Albany, NY
National Provider Identifier
1093978926
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
279725 Issued in NY
Practice address
47 New Scotland Ave
MC 88
Albany, NY 12208-3412
Phone
(519) 262-8831
Fax
(518) 262-6453
NPI assigned
Jul 10, 2008
Last updated
Jul 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 279725 NY Primary

Addresses

Primary practice location

47 New Scotland Ave
MC 88
Albany, NY 12208-3412

Mailing address

47 New Scotland Ave
MC 88
Albany, NY 12208-3412
Phone (519) 262-8831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923003134 NY Practitioner - Pediatric Medicine 0648413658 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279725NYMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Jul 6, 2015 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Pediatric Gastroenterology CurrentSince Jul 6, 2015 Accepting new patients

Locations

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
#88
Albany, NY 12208
Phone (518) 262-6880

Organizations & group practices 5

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1093978926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "address_2": "MC 88",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "519-262-8831",
            "fax_number": "518-262-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE",
            "address_2": "MC 88",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "519-262-8831",
            "fax_number": "518-262-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INFANTINO",
        "first_name": "BENJAMIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "279725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.