Individual provider Active NPI

Hunter R Macdonald, DO

  • Pediatrics Physician
  • Latham, NY
National Provider Identifier
1174152052
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
322794 Issued in NY
Practice address
6 Wellness Way Ste 102
Latham, NY 12110-2156
Phone
(518) 713-2099
Fax
(518) 783-7506
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 322794 NY Primary

Addresses

Primary practice location

6 Wellness Way Ste 102
Latham, NY 12110-2156

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

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
I20230718001184 NY Practitioner - Pediatric Medicine 3173983418 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Oct 25, 2024 Accepting new patients
Community Care Physicians, PLLC Pediatrics CurrentSince Aug 21, 2023 Accepting new patients
Community Care Physicians, PC Past Accepting new patients
Community Care Physicians, PC Pediatrics PastSince May 1, 2023 Accepting new patients

Locations

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

711 Troy Schenectady Rd
Ste 101
Latham, NY 12110

6 Wellness Way
Ste 102
Latham, NY 12110
Phone (518) 713-2099

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

624 McClellan St
Ste G2
Schenectady, NY 12304
Phone (518) 382-2203

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1174152052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "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": "6 WELLNESS WAY STE 102",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-713-2099",
            "fax_number": "518-783-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "HUNTER",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "322794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.