Individual provider Active NPI

Samuel Smith Caldwell, M.D.

  • Orthopaedic Surgery Physician
  • Saratoga Springs, NY
National Provider Identifier
1396744520
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
147389 Issued in NY
Practice address
19 West Ave
Suite 102
Saratoga Springs, NY 12866-6052
Phone
(518) 584-0295
Fax
(518) 584-0296
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 147389 NY Primary

Addresses

Primary practice location

19 West Ave
Suite 102
Saratoga Springs, NY 12866-6052

Mailing address

19 West Ave
Suite 102
Saratoga Springs, NY 12866-6052
Phone (518) 584-0295

Other identifiers 1

IdentifierTypeStateIssuer
00733124MedicaidNY

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
I20090622000212 NY Practitioner - Orthopedic Surgery 2567522113 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147389NYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Region Orthopaedic Associates, PC Orthopaedic Surgery CurrentSince May 1, 2009 Accepting new patients

Locations

1367 Washington Ave
Ste 200
Albany, NY 12206
Phone (518) 489-2666

19 West Ave
Ste 102
Saratoga Springs, NY 12866
Phone (518) 584-0295

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1396744520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WEST AVE",
            "address_2": "SUITE 102",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666052",
            "telephone_number": "518-584-0295",
            "fax_number": "518-584-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WEST AVE",
            "address_2": "SUITE 102",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666052",
            "telephone_number": "518-584-0295",
            "fax_number": "518-584-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "SAMUEL",
        "middle_name": "SMITH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "147389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00733124",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.