Active NPI
Akhilesh Fotidar, MD
- Internal Medicine Physician
- Gloversville, NY
National Provider Identifier
1881623635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 220653
- Practice address
- 99 E State St
Mab-GPCC
Gloversville, NY 12078-1203 - Phone
- (518) 773-5690
- Fax
- (518) 773-5620
- NPI assigned
- Jul 2, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 220653 | NY | Primary |
Addresses
Primary practice location
99 E State St
Mab-GPCC
Gloversville, NY 12078-1203
Mailing address
99 E State St
PO Box 1250
Gloversville, NY 12078-1203
Phone (518) 773-5690
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01806124 | Medicaid | NY | |
| 000499168001 | Other | NY | BSH NE NY |
| 110222 | Other | NY | MVP HEALTHCARE |
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 |
|---|---|---|---|
| 220653 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nathan Littauer Hospital Association | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Skilled Nursing Facility
- Gloversville, NY
- NPI 1073541850
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421798400000",
"number": "1881623635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 E STATE ST",
"address_2": "PO BOX 1250",
"city": "GLOVERSVILLE",
"state": "NY",
"postal_code": "120781203",
"telephone_number": "518-773-5690",
"fax_number": "518-773-5620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 E STATE ST",
"address_2": "MAB-GPCC",
"city": "GLOVERSVILLE",
"state": "NY",
"postal_code": "120781203",
"telephone_number": "518-773-5690",
"fax_number": "518-773-5620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOTIDAR",
"first_name": "AKHILESH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-02",
"last_updated": "2015-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "220653",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01806124",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSH NE NY",
"identifier": "000499168001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP HEALTHCARE",
"identifier": "110222",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gloversville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.