Active NPI
Patrick A. Fantauzzi, M.D.
- Anesthesiology Physician
- Albany, NY
National Provider Identifier
1962407213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 104048-1
- Practice address
- 1450 Western Ave
Suite 102
Albany, NY 12203-3539 - Phone
- (518) 463-0050
- Fax
- (518) 207-2973
- NPI assigned
- Jun 14, 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 104048-1 | NY | Primary |
Addresses
Primary practice location
1450 Western Ave
Suite 102
Albany, NY 12203-3539
Mailing address
1450 Western Ave
Suite 102
Albany, NY 12203-3539
Phone (518) 463-0050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104048-1 | NY | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386806400000",
"number": "1962407213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 WESTERN AVE",
"address_2": "SUITE 102",
"city": "ALBANY",
"state": "NY",
"postal_code": "122033539",
"telephone_number": "518-463-0050",
"fax_number": "518-207-2973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 WESTERN AVE",
"address_2": "SUITE 102",
"city": "ALBANY",
"state": "NY",
"postal_code": "122033539",
"telephone_number": "518-463-0050",
"fax_number": "518-207-2973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANTAUZZI",
"first_name": "PATRICK",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2013-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "104048-1",
"primary": true
}
],
"identifiers": [],
"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 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.