Individual provider Active NPI

Ronald L Dick, MD

  • Pediatrics Physician
  • Albany, NY
National Provider Identifier
1275614539
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60-273120 Issued in NY
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

Updated by the provider on Dec 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
8113268MedicaidWA
7246OtherINTERNAL 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140325000250 NY Practitioner - Pediatric Medicine 2163557885 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60-273120NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Pediatrics Current Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Pediatrics CurrentSince Feb 3, 2014 Accepting new patients
Albany Medical College CurrentSince Feb 3, 2014 Accepting new patients
Albany Medical College Pediatrics CurrentSince Apr 1, 2019 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.

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

Verify at the official NPI Registry.