Active NPI
Robert L Decarlo, MD
- Podiatrist
- New Hartford, NY
National Provider Identifier
1831187590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 002568
- Practice address
- 1729 Burrstone Road
New Hartford, NY 13413 - Phone
- (315) 798-1460
- Fax
- (315) 798-1872
- NPI assigned
- Oct 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 002568 | NY | Primary |
Addresses
Primary practice location
1729 Burrstone Road
New Hartford, NY 13413
Mailing address
1729 Burrstone Road
Slocum Dickson Medical Group
New Hartford, NY 13413
Phone (315) 798-1460
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00401932 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002568 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1831187590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1729 BURRSTONE ROAD",
"address_2": "SLOCUM DICKSON MEDICAL GROUP",
"city": "NEW HARTFORD",
"state": "NY",
"postal_code": "13413",
"telephone_number": "315-798-1460",
"fax_number": "315-798-1872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1729 BURRSTONE ROAD",
"city": "NEW HARTFORD",
"state": "NY",
"postal_code": "13413",
"telephone_number": "315-798-1460",
"fax_number": "315-798-1872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECARLO",
"first_name": "ROBERT",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-07",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "002568",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00401932",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Hartford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.