Jacqueline Videtto, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

016854 Issued in NY

Practice address

100 Veterans Blvd Ste 1
Massapequa, NY 11758-4945

Phone

(516) 882-9600

Fax

(516) 882-9605

NPI assigned

Sep 5, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Michael Sacher DO PC

  • Specialist
  • Massapequa, NY
  • NPI 1922009893
  NPD (past)

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1083049480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VETERANS BLVD STE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117584945",
            "telephone_number": "516-882-9600",
            "fax_number": "516-882-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VETERANS BLVD STE 1",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117584945",
            "telephone_number": "516-882-9600",
            "fax_number": "516-882-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDETTO",
        "first_name": "JACQUELINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "016854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Varughese
• Stephanie Helen Veltre
• Frank Ventimiglia, L.AC.
• Joseph B Vertuccio
• Nicole Marie Vessalico
• Thomas James Vigliante, D.D.S.
• Sophia Esperanza Villa
• Ashley S Villalba
• Joanne C. Villani, P.T.
• Karla Villanueva

• Medical Physician Assistant in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.

Verify at the official NPI Registry.