Individual provider Active NPI

Robert J. Accettola, M.D.

  • Cardiovascular Disease Physician
  • Portsmouth, VA
National Provider Identifier
1053428862
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0101039484 Issued in VA
Practice address
3737 High St
Portsmouth, VA 23707-2405
Phone
(757) 686-9400
Fax
(757) 686-9449
NPI assigned
Aug 25, 2006
Last updated
Jan 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101039484 VA Primary

Addresses

Primary practice location

3737 High St
Portsmouth, VA 23707-2405

Mailing address

3737 High St
Portsmouth, VA 23707-2405
Phone (757) 686-9400

Other identifiers 1

IdentifierTypeStateIssuer
O10109060MedicaidVA

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1053428862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237072405",
            "telephone_number": "757-686-9400",
            "fax_number": "757-686-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237072405",
            "telephone_number": "757-686-9400",
            "fax_number": "757-686-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACCETTOLA",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101039484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "O10109060",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.