Eric Fethke, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

195450 Issued in NY

Practice address

212 Crystal Run Rd
Middletown, NY 10941-4009

Phone

(845) 703-7000

Fax

(845) 703-0160

NPI assigned

Feb 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Cardiovascular Disease (Cardiology)Also: Pediatric Medicine

Education

Columbia University College of Physicians and Surgeons, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boston Children'S Health Physicians LLPGroup PAC ID 8325937014, 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: eric.fethke.p1@direct.cwpw.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Boston Children'S Health Physicians, LLP

  • Pediatrics Physician
  • Hawthorne, NY
  • NPI 1467454967

  Pediatric Cardiology

  Medicare reassignment Care Compare group NPD
• The Center for Discovery Inc

  • Rural Health Clinic/Center
  • Monticello, NY
  • NPI 1275624694
  Medicare reassignment NPD
• Boston Childrens Health Physicians LLP

  dba Boston Childrens Health Physicians Pediatric Endocrinology Division

  • Clinical Medical Laboratory
  • Sleepy Hollow, NY
  • NPI 1588651079
  NPD
• The Center for Discovery Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Rock Hill, NY
  • NPI 1669202610
  NPD

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1285600080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414009",
            "telephone_number": "845-703-7000",
            "fax_number": "845-703-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414009",
            "telephone_number": "845-703-7000",
            "fax_number": "845-703-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETHKE",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "195450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01488665",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica L Ferraiolo, RPA-C
• Heather Ashley Ferrante
• Lisa Ferrara
• Rebekah Ann Ferrier, M.ED., BCBA, LBA
• Darci Carin Ferry, RN
• Carisa Fick, AGNP-C
• Jeanette Figueroa, RPA-C
• Yvette Figueroa, NP
• Daniel Finn, PA-C
• Karen Finnigan, MD, MBA

• Pediatric Cardiology Physician in Middletown, NY
• Providers in Middletown, NY by specialty
• Pediatric Cardiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.