Individual provider Active NPI

Amy E. Spoto, MD

  • Pediatrics Physician
  • Middletown, NY
National Provider Identifier
1508866187
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
224474 Issued in NY
Practice address
100 Crystal Run Rd
Suite 107
Middletown, NY 10941-4041
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
Jul 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 224474 NY Primary

Addresses

Primary practice location

100 Crystal Run Rd
Suite 107
Middletown, NY 10941-4041

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

Other identifiers 1

IdentifierTypeStateIssuer
02410066MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.spotomd.p1@direct.crystalrun.nextgenshare.com Direct

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
I20050210000539 NY Practitioner - Pediatric Medicine 0042262750 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224474NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Run Healthcare Physicians LLP CurrentSince Jan 1, 2012 Accepting new patients
Crystal Run Healthcare Physicians LLP CurrentSince Jan 1, 2012 Accepting new patients

Locations

100 Crystal Run Rd
Middletown, NY 10941
Phone (845) 692-8200

100 Crystal Run Rd
Ste 107
Middletown, NY 10941
Phone (845) 692-6996

155 Crystal Run Rd
Middletown, NY 10941

300 Crystal Run Rd
Middletown, NY 10941
Phone (845) 692-6999

Networks

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

Interoperability endpoints

  • Direct secure messaging: aspoto143666@direct.optum.com

Organizations & group practices 2

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1508866187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CRYSTAL RUN RD",
            "address_2": "SUITE 107",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414041",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOTO",
        "first_name": "AMY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "224474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02410066",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.spotomd.p1@direct.crystalrun.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Crystal Run Rd",
            "address_2": "Suite 107",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109414041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.