Andrea Vanessa Caraccioli, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

61933 Issued in MN

Practice address

404 W Fountain St
Albert Lea, MN 56007-2437

Phone

(507) 373-2384

NPI assigned

Apr 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dedicated Missouri Holding, LLC

  • Internal Medicine Physician
  • Miami Gardens, FL
  • NPI 1053958082

  MO

  Medicare reassignment
• Dedicated Missouri Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Saint Louis, MO
  • NPI 1558909150
  NPD
• Dedicated Missouri Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Saint Louis, MO
  • NPI 1154968196
  NPD (past)
• Dedicated Missouri Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Saint Louis, MO
  • NPI 1790317402
  NPD (past)

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1083057970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 1ST DR NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122941",
            "telephone_number": "507-433-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W FOUNTAIN ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072437",
            "telephone_number": "507-373-2384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Main Street",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117068004",
            "country_code": "US",
            "telephone_number": "631-968-3295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARACCIOLI",
        "first_name": "ANDREA",
        "middle_name": "VANESSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "285077",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "61933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Buendorf, APRN
• Julianne S Bulau, MSW LICSW
• Richard Allen Buringa, C.R.N.A.
• Amy Busall
• Sheila Calderon, CNP, FNP, RN
• Clarence Roy Carlson Jr., D.O.
• Jennifer Anne Chalmers, PT
• Larissa Chapman, RDN
• Mary A Christensen, M.D.
• Kay Joann Christianson, RN

• Hospitalist Physician in Albert Lea, MN
• Providers in Albert Lea, MN by specialty
• Hospitalist Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.