Individual provider Active NPI

Matthew John Fordham

  • Cardiovascular Disease Physician
  • Albany, NY
National Provider Identifier
1659909349
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
329887 Issued in NY
Practice address
2 Palisades Dr
Albany, NY 12205-1438
Phone
(518) 458-2000
Fax
(518) 458-1524
NPI assigned
Mar 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 329887 NY Primary

Addresses

Primary practice location

2 Palisades Dr
Albany, NY 12205-1438

Mailing address

PO Box 14890
Albany, NY 12212-4890

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.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
I20241007002310 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2062943624 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
329887NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health Partners Medical Associates, P.C. Cardiovascular Disease CurrentSince Aug 24, 2024 Accepting new patients

Locations

2 Palisades Dr
Albany, NY 12205

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

1301 River St
Ste 204
Valatie, NY 12184
Phone (518) 392-8600

Interoperability endpoints

  • Direct secure messaging: mfordham3498075@direct.trinity-health.org
  • Direct secure messaging: mfordham24572@albanymed.direct-ci.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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1659909349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PALISADES DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051438",
            "telephone_number": "518-458-2000",
            "fax_number": "518-458-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDHAM",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "329887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2 Palisades Dr",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122051438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.