Active NPI
John H Malfetano, M.D.
- Gynecologic Oncology Physician
- Albany, NY
National Provider Identifier
1861420911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecologic Oncology Physician
- License
- 154115
- Practice address
- 24 Computer Dr W
Ste 100
Albany, NY 12205-1612 - Phone
- (518) 689-7548
- Fax
- (518) 489-7548
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gynecologic Oncology Physician | 207VX0201X | 154115 | NY | Primary |
Addresses
Primary practice location
24 Computer Dr W
Ste 100
Albany, NY 12205-1612
Mailing address
24 Computer Dr W
Ste 100
Albany, NY 12205-1612
Phone (518) 689-7548
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00775333 | Medicaid | NY | |
| 10005938 | Other | NY | CDPHP |
| 141811164 | Other | NY | BLUE SHIELD NENY |
| 69150 | Other | NY | MVP |
| 110038 | Other | NY | WELLCARE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481673600000",
"number": "1861420911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 COMPUTER DR W",
"address_2": "STE 100",
"city": "ALBANY",
"state": "NY",
"postal_code": "122051612",
"telephone_number": "518-689-7548",
"fax_number": "518-489-7548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 COMPUTER DR W",
"address_2": "STE 100",
"city": "ALBANY",
"state": "NY",
"postal_code": "122051612",
"telephone_number": "518-689-7548",
"fax_number": "518-489-7548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALFETANO",
"first_name": "JOHN",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2016-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0201X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecologic Oncology",
"state": "NY",
"license": "154115",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00775333",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10005938",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD NENY",
"identifier": "141811164",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "69150",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "110038",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.