NPIMap

Individual provider Active NPI

Lance Eugene Sullenberger, MD

  • Cardiovascular Disease Physician
  • Albany, NY
National Provider Identifier
1174623086
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
247198 Issued in NY
Practice address
7 Southwoods Blvd
Capital Cardiology Associates, PC
Albany, NY 12211-2526
Phone
(518) 292-6000
Fax
(518) 292-6050
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101058708 VA
Cardiovascular Disease Physician 207RC0000X 247198 NY Primary

Addresses

Primary practice location

7 Southwoods Blvd
Capital Cardiology Associates, PC
Albany, NY 12211-2526

Mailing address

7 Southwoods Blvd
Capital Cardiology Associates, PC
Albany, NY 12211-2526
Phone (518) 292-6000

Other identifiers 4

IdentifierTypeStateIssuer
1015882MedicaidVT
2156164MedicaidMA
P00679142OtherNYMEDICARE, RAILROAD
02961168MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080404000112 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Advanced Heart Failure and Transplant Cardiology 7416034269 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Advanced Heart Failure and Transplant Cardiology
Education
Georgetown University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Movn Health Medical Group PLLCGroup PAC ID 8123423563, 8 clinicians
Capital Cardiology Associates PLLCGroup PAC ID 1254228240, 72 clinicians

Practice addresses (Care Compare)

Albany, NY 12206
Phone (833) 426-6686

7 Southwoods Blvd
Albany, NY 12211-2514
Phone (519) 292-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.58 of 100Reported as individual
Quality
72.93
Promoting interoperability
100
Improvement activities
40
Cost
72.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101058708VAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College Cardiovascular Disease CurrentSince Oct 21, 2013 Accepting new patients
Community Care Physicians, PLLC CurrentSince Aug 1, 2021 Accepting new patients
Albany Medical College CurrentSince Oct 21, 2013 Accepting new patients
Movn Health Medical Group PLLC Cardiovascular Disease CurrentSince Jan 1, 2023 Accepting new patients
Athletic Dynamics LLC Past Accepting new patients
Albany Medical Center Hospital Past Accepting new patients
Burdett Orthopedics, PC PastSince Mar 1, 2010 Accepting new patients

Locations

3415 S Sepulveda Blvd
Ste 1168
Los Angeles, CA 90034

7 Southwoods Blvd
Ste 4
Albany, NY 12211

7 Southwoods Blvd
Albany, NY 12211
Phone (518) 292-6060

7 Southwoods Blvd
Fl 4
Albany, NY 12211
Phone (518) 641-6775

279 Central Ave
Albany, NY 12206

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

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

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

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

711 Troy Schenectady Rd
Ste 114
Latham, NY 12110
Phone (518) 783-7070

6 Medical Park Dr
Ste 203
Malta, NY 12020
Phone (518) 264-1200

1769 Union St
Ste 2
Niskayuna, NY 12309
Phone (518) 382-1151

2200 Burdett Ave
Ste 202
Troy, NY 12180
Phone (518) 272-0122

Interoperability endpoints

  • Direct secure messaging: lsullenberger19451@albanymed.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1174623086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SOUTHWOODS BLVD",
            "address_2": "CAPITAL CARDIOLOGY ASSOCIATES, PC",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122112526",
            "telephone_number": "518-292-6000",
            "fax_number": "518-292-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SOUTHWOODS BLVD",
            "address_2": "CAPITAL CARDIOLOGY ASSOCIATES, PC",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122112526",
            "telephone_number": "518-292-6000",
            "fax_number": "518-292-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLENBERGER",
        "first_name": "LANCE",
        "middle_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101058708",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "247198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015882",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2156164",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, RAILROAD",
            "identifier": "P00679142",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02961168",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.