Individual provider Active NPI

Fei Yang Xu

  • General Practice Dentistry
  • Latham, NY
National Provider Identifier
1851648927
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
056229 Issued in NY
Practice address
1201 Troy Schenectady Rd
Latham, NY 12110-1028
Phone
(518) 785-3084
Fax
(518) 785-0243
NPI assigned
Aug 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 056229 NY Primary

Addresses

Primary practice location

1201 Troy Schenectady Rd
Latham, NY 12110-1028

Mailing address

SPHP Payer Credentialing 4 Palisades Drive
Suite 200
Albany, NY 12205
Phone (518) 591-1121

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170626000142 NY Practitioner - DentistPractitioner - Oral Surgery 7618269622 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany CurrentSince Apr 23, 2017 Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Apr 23, 2017 Accepting new patients
Capital Area Hudson Valley New York Dental, PC Past Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

4 Palisades Dr
Ste 200
Albany, NY 12205
Phone (518) 591-1121

53 Columbia St
Rensselaer, NY 12144
Phone (518) 434-2526

Organizations & group practices 3

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": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1851648927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SPHP PAYER CREDENTIALING 4 PALISADES DRIVE",
            "address_2": "SUITE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12205",
            "telephone_number": "518-591-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 TROY SCHENECTADY RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101028",
            "telephone_number": "518-785-3084",
            "fax_number": "518-785-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XU",
        "first_name": "FEI",
        "middle_name": "YANG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "056229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.