Healthcare Provider Details

I. General information

NPI: 1538160700
Provider Name (Legal Business Name): MATTHEW R DICAPRIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1367 WASHINGTON AVE
ALBANY NY
12206-1069
US

IV. Provider business mailing address

1367 WASHINGTON AVE
ALBANY NY
12206-1069
US

V. Phone/Fax

Practice location:
  • Phone: 518-489-2666
  • Fax:
Mailing address:
  • Phone: 518-489-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number231602
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number231602
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number231602
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number231602
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: