Active NPI
Ronald L Dick, MD
- Pediatrics Physician
- Albany, NY
National Provider Identifier
1275614539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 60-273120
- Practice address
- 47 New Scotland Ave
MC-88
Albany, NY 12208-3412 - Phone
- (518) 262-0218
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD00025625 | WA | |
| Pediatrics Physician | 208000000X | 60-273120 | NY | Primary |
Addresses
Primary practice location
47 New Scotland Ave
MC-88
Albany, NY 12208-3412
Mailing address
47 New Scotland Ave
MC-88
Albany, NY 12208-3412
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8113268 | Medicaid | WA | |
| 7246 | Other | INTERNAL ID-MOTOR VEHICLE ID |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60-273120 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albany Medical College | Pediatrics | Current | Accepting new patients |
| Albany Medical College | Current | Accepting new patients | |
| Albany Medical College | Pediatrics | Current | Accepting new patients |
| Albany Medical College | Current | Accepting new patients | |
| Albany Medical College | Pediatrics | Current | Accepting new patients |
Locations
47 New Scotland Ave
#88
Albany, NY 12208
Phone (518) 262-5120
47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773
1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705
Organizations & group practices 5
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.
-
- Urgent Care Clinic/Center
- Albany, NY
- NPI 1386038925
-
- Allergy & Immunology Physician
- Albany, NY
- NPI 1386689248
-
- Physical Medicine & Rehabilitation Physician
- Albany, NY
- NPI 1629008537
Pediatrics
-
- Pediatrics Physician
- Albany, NY
- NPI 1750315636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387756800000",
"number": "1275614539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 NEW SCOTLAND AVE",
"address_2": "MC-88",
"city": "ALBANY",
"state": "NY",
"postal_code": "122083412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 NEW SCOTLAND AVE",
"address_2": "MC-88",
"city": "ALBANY",
"state": "NY",
"postal_code": "122083412",
"telephone_number": "518-262-0218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICK",
"first_name": "RONALD",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2013-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00025625",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "60-273120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8113268",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNAL ID-MOTOR VEHICLE ID",
"identifier": "7246",
"state": null
}
],
"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 Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.