Individual provider Active NPI

Vicki-Jo Deutsch, MD

  • Skilled Nursing Facility
  • New York, NY
National Provider Identifier
1003972472
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
159256 Issued in NY
Practice address
330 East 17TH St
New York, NY 10003
Phone
(212) 420-2000
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 159256 NY Primary

Addresses

Primary practice location

330 East 17TH St
New York, NY 10003

Mailing address

1249 5TH Ave
New York, NY 10029-4413
Phone (212) 360-3925

Other identifiers 1

IdentifierTypeStateIssuer
00866853MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151008000081 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3678881844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
159256NYMDSkilled Nursing Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Terence Cardinal Cooke Health Care Center Past Accepting new patients
Beth Israel Medical Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1003972472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294413",
            "telephone_number": "212-360-3925",
            "fax_number": "212-289-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 EAST 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-420-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEUTSCH",
        "first_name": "VICKI-JO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "159256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00866853",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.