Individual provider Active NPI

Mark Lester Fruiterman, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Albany, NY
National Provider Identifier
1609879709
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
116938 Issued in NY
Practice address
1365 Washington Ave
Ste 300
Albany, NY 12206-1098
Phone
(518) 489-4704
Fax
(518) 489-0512
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 116938 NY Primary

Addresses

Primary practice location

1365 Washington Ave
Ste 300
Albany, NY 12206-1098

Mailing address

1365 Washington Ave
Ste 300
Albany, NY 12206-1098
Phone (518) 489-4704

Other identifiers 1

IdentifierTypeStateIssuer
00438459MedicaidNY

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
I20050929000135 NY Practitioner - Endocrinology 5092628446 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Endocrinology, Diabetes & Metabolism CurrentSince Jun 1, 2019 Accepting new patients
Albany Medical College CurrentSince Apr 1, 2014 Accepting new patients
Albany Medical College Endocrinology, Diabetes & Metabolism CurrentSince Apr 1, 2014 Accepting new patients
The Endocrine Group Endocrinology, Diabetes & Metabolism Past Accepting new patients

Locations

1365 Washington Ave
Ste 300
Albany, NY 12206
Phone (518) 489-4704

1365 Washington Ave
Albany, NY 12206
Phone (518) 435-1300

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

Organizations & group practices 4

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609879709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 WASHINGTON AVE",
            "address_2": "STE 300",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061098",
            "telephone_number": "518-489-4704",
            "fax_number": "518-489-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 WASHINGTON AVE",
            "address_2": "STE 300",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061098",
            "telephone_number": "518-489-4704",
            "fax_number": "518-489-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUITERMAN",
        "first_name": "MARK",
        "middle_name": "LESTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "116938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00438459",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.