Individual provider Active NPI

Victoria Vamos, NP

  • Family Nurse Practitioner
  • Holbrook, NY
National Provider Identifier
1083669915
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
333441 Issued in NY
Practice address
751 Coates Ave Ste 31
Holbrook, NY 11741-6039
Phone
(631) 580-0000
Fax
(631) 580-0001
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 333441 NY Primary

Addresses

Primary practice location

751 Coates Ave Ste 31
Holbrook, NY 11741-6039

Mailing address

751 Coates Ave Ste 31
Holbrook, NY 11741-6039
Phone (631) 580-0000

Other practice location 1

1 Cvs Dr
Woonsocket, RI 02895-6146
Phone (866) 389-2727

Other identifiers 2

IdentifierTypeStateIssuer
1083669915OtherNYUNIVERSAL IDENTIFICATION
02633829MedicaidNY

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041025001061 NY Practitioner - Nurse Practitioner 1456312172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

751 Coates Ave
Suite 31
Holbrook, NY 11741-6039
Phone (631) 580-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
333441NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Vamos, Nurse Practitioner in Family Health, P.C. CurrentSince Jul 20, 2015 Accepting new patients
Doshi Diagnostic Imaging Services PC Past Accepting new patients

Locations

751 Coates Ave
Ste 31
Holbrook, NY 11741
Phone (631) 580-0000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1083669915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 COATES AVE STE 31",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117416039",
            "telephone_number": "631-580-0000",
            "fax_number": "631-580-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 COATES AVE STE 31",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117416039",
            "telephone_number": "631-580-0000",
            "fax_number": "631-580-0001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Cvs Dr",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028956146",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAMOS",
        "first_name": "VICTORIA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "333441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL IDENTIFICATION",
            "identifier": "1083669915",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02633829",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

Verify at the official NPI Registry.