NPIMap

Organization Active NPI

Capital District Pediatric Cardiology Associates PC

  • Pediatric Cardiology Physician
  • Albany, NY
National Provider Identifier
1407923873
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
CAPITAL DISTRICT PEDIATRIC CARDIOLOGY ASSOCIATES PC
Practice address
319 S Manning Blvd
Suite 203
Albany, NY 12208
Phone
(518) 489-3292
Fax
(518) 453-6286
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Dr. Eric W SpoonerNPI 1235214099
Title
President
Phone
(518) 489-3292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

319 S Manning Blvd
Suite 203
Albany, NY 12208

Mailing address

319 S Manning Blvd
Suite 203
Albany, NY 12208
Phone (518) 489-3292

Other identifiers 1

IdentifierTypeStateIssuer
00509839MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080327000184 NY Part B Supplier - Clinic/Group Practice 2163508466 Receives reassigned benefits from 6 practitioners
Practice locations: Albany, NY

National Provider Directory

National Provider Directory

Locations

319 S Manning Blvd
Ste 203
Albany, NY 12208
Phone (518) 489-3292

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1407923873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 S MANNING BLVD",
            "address_2": "SUITE 203",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-489-3292",
            "fax_number": "518-453-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S MANNING BLVD",
            "address_2": "SUITE 203",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12208",
            "telephone_number": "518-489-3292",
            "fax_number": "518-453-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL DISTRICT PEDIATRIC CARDIOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "SPOONER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-489-3292",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00509839",
            "state": "NY"
        }
    ],
    "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 May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.