Individual provider Active NPI

Robert Hedderman, M.D.

  • Orthopaedic Surgery Physician
  • Albany, NY
National Provider Identifier
1194745737
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
161357-9 Issued in NY
Practice address
1367 Washington Ave
Suite 200
Albany, NY 12206-1043
Phone
(518) 489-2666
Fax
(518) 489-5933
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 161357-9 NY Primary

Addresses

Primary practice location

1367 Washington Ave
Suite 200
Albany, NY 12206-1043

Mailing address

1367 Washington Ave
Suite 200
Albany, NY 12206-1043
Phone (518) 489-2666

Other identifiers 6

IdentifierTypeStateIssuer
01184674MedicaidNY
18127OtherNYMVP
4577474OtherNYAETNA
75F361OtherNYEMPIRE BLUE CROSS
000405988001OtherNYBS NENY
10000864OtherNYCDPHP

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
I20080805000919 NY Practitioner - Orthopedic Surgery 9830181486 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
161357-9NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Region Orthopaedic Associates, PC Orthopaedic Surgery CurrentSince Jul 18, 2008 Accepting new patients

Locations

1367 Washington Ave
Ste 200
Albany, NY 12206
Phone (518) 489-2666

146 Jefferson Hts
Ste 101
Catskill, NY 12414
Phone (518) 943-0667

989 Route 146
Ste 200
Clifton Park, NY 12065
Phone (518) 383-0891

Interoperability endpoints

  • Direct secure messaging: rhedderman788284@direct.trinity-health.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1194745737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE",
            "address_2": "SUITE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061043",
            "telephone_number": "518-489-2666",
            "fax_number": "518-489-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE",
            "address_2": "SUITE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061043",
            "telephone_number": "518-489-2666",
            "fax_number": "518-489-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDDERMAN",
        "first_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "161357-9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01184674",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "18127",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4577474",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "75F361",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS NENY",
            "identifier": "000405988001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10000864",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.