Individual provider Active NPI

Eric W Spooner

  • Pediatric Cardiology Physician
  • Albany, NY
National Provider Identifier
1235214099
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
1308601 Issued in NY
Practice address
319 S Manning Blvd
Suite 203
Albany, NY 12208
Phone
(518) 489-3292
Fax
(518) 453-6286
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 1308601 NY Primary

Addresses

Primary practice location

319 S Manning Blvd
Suite 203
Albany, NY 12208

Mailing address

319 S Manning Blvd
Suite 203
Albany, NY 12208
Phone (518) 489-3292

Other identifiers 1

IdentifierTypeStateIssuer
00369080MedicaidNY

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1308601NYMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital District Pediatric Cardiology Associates PC Pediatric Cardiology PastSince Sep 11, 1996 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: espooner29798@albanymed.direct-ci.com

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235214099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 S MANNING BLVD",
            "address_2": "SUITE 203",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-489-3292",
            "fax_number": "518-453-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S MANNING BLVD",
            "address_2": "SUITE 203",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-489-3292",
            "fax_number": "518-453-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOONER",
        "first_name": "ERIC",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "1308601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00369080",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.