DR. ERIC FETHKE M.D.
NPI 1285600080
Pediatrics - Pediatric Cardiology in Middletown, NY

Q: What is Eric Fethke's NPI number?

The NPI number for Eric Fethke is 1285600080. It was assigned to this individual provider in the NPPES registry on February 23, 2006.

Q: What is Eric Fethke's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Q: When was this NPI record last updated?

The NPPES record for Eric Fethke was last updated on February 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 23, 2006PECOS EnrolledAccepts Medicare Assignment

212 CRYSTAL RUN RD, MIDDLETOWN, NY 10941(845) 703-7000(845) 703-0160 Get Directions Write a Review

NPPES record last updated: February 7, 2013. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Dr. Eric Fethke M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ERIC FETHKE M.D. (NPI 1285600080) is an individual pediatric cardiology provider in Middletown, New York, licensed in New York (195450) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of Columbia University College Of Physicians And Surgeons (1991).

NPPES Registry Identity

NPI1285600080

Entity TypeIndividualMale

Primary Taxonomy2080P0202X

Provider Legal NameDR. ERIC FETHKECredential: M.D.

Location Address212 CRYSTAL RUN RDMiddletown, NY 10941-4009

Mailing Address212 Crystal Run RdMiddletown, NY 10941-4009 · (845) 703-7000 · Fax (845) 703-0160

Phone(845) 703-7000

Fax(845) 703-0160

Sole ProprietorYes

Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 1991

Enumeration DateFebruary 23, 2006

Last NPPES UpdateFebruary 7, 2013

✔ NPI 1285600080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0202X

License✔ Licensed in NY · 195450

Definition

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

212 CRYSTAL RUN RD, Middletown, NY 10941

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Other Identifiers 3

Medicare UPINH35670NY

Medicare ID-Type Unspecified550871NY

Medicaid01488665NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Eric Fethke M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547347858

PECOS Enrollment IDI20080411000047

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDSEY ALT PA-C

Physician Assistant (Medical)