Individual provider Active NPI

Daniel Vanderbilt, MD,PHD

  • Radiation Oncology Physician
  • New Hartford, NY
National Provider Identifier
1578096756
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MD61334616 Issued in WA
Practice address
2 Ellinwood Dr
New Hartford, NY 13413-1102
Phone
(315) 316-0670
Fax
(315) 316-0681
NPI assigned
Apr 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MD61334616 WA Primary

Addresses

Primary practice location

2 Ellinwood Dr
New Hartford, NY 13413-1102

Mailing address

1 Medical Center Dr
P.O. Box 9001-a
Morgantown, WV 26506-1200
Phone (304) 293-2463

Other practice location 1

1226 E Water St
Syracuse, NY 13210-1155
Phone (315) 478-3468

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
I20240112000235 NY Practitioner - Radiation Oncology 4587934930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
West Virginia University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Medical Professionals of Ny PLLCGroup PAC ID 0749378123, 57 clinicians

Practice addresses (Care Compare)

2 Ellinwood Dr
New Hartford, NY 13413-1110
Phone (315) 724-1012

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Wynn Hospital Hospital, Utica, NY, CCN 330044
  • Oneida Health Hospital Hospital, Oneida, NY, CCN 330115

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Medical Professionals of Ny, PLLC CurrentSince Feb 1, 2024 Accepting new patients
Associated Medical Professionals of Ny, PLLC Radiation Oncology CurrentSince Feb 1, 2024 Accepting new patients

Locations

100 Metropolitan Park Dr
Ste 100
Liverpool, NY 13088
Phone (315) 870-9370

2 Ellinwood Dr
New Hartford, NY 13413
Phone (315) 507-5081

1226 E Water St
Syracuse, NY 13210
Phone (315) 423-7226

Interoperability endpoints

  • Direct secure messaging: dvanderbilt@ampofny.medentdirect.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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1578096756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "P.O. BOX 9001-A",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061200",
            "telephone_number": "304-293-2463",
            "fax_number": "304-293-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ELLINWOOD DR",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131102",
            "telephone_number": "315-316-0670",
            "fax_number": "315-316-0681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1226 E Water St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101155",
            "country_code": "US",
            "telephone_number": "315-478-3468",
            "fax_number": "315-214-2840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERBILT",
        "first_name": "DANIEL",
        "credential": "MD,PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-05",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "MD61334616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

Verify at the official NPI Registry.