Individual provider Active NPI

Morgan Joseph Vittengl, MD

  • Family Medicine Physician
  • Ballston Spa, NY
National Provider Identifier
1245305291
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
170365 Issued in NY
Practice address
2554 Rte 9
Ballston Spa, NY 12020
Phone
(518) 899-5002
Fax
(518) 899-5603
NPI assigned
Nov 22, 2006
Last updated
May 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 170365 NY Primary

Addresses

Primary practice location

2554 Rte 9
Ballston Spa, NY 12020

Mailing address

2554 Rte 9
Ballston Spa, NY 12020
Phone (518) 899-5002

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
I20090720000298 NY Practitioner - Family Practice 5698827806

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170365NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Ryan Family Health Nurse Practitioner, PLLC CurrentSince Apr 6, 2023 Accepting new patients

Locations

2554 State Route 9
Malta, NY 12020
Phone (518) 899-5002

Organizations & group practices 2

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1245305291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 RTE 9",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "12020",
            "telephone_number": "518-899-5002",
            "fax_number": "518-899-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 RTE 9",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "12020",
            "telephone_number": "518-899-5002",
            "fax_number": "518-899-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITTENGL",
        "first_name": "MORGAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "170365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Spa, NY

Sources for this page

Verify at the official NPI Registry.