Organization Active NPI

Victoria Vamos, Nurse Practitioner in Family Health, P.C.

Doing business as Long Island Medical and Spa

  • Family Health Clinical Nurse Specialist
  • Holbrook, NY
National Provider Identifier
1104202993
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
F333441 Issued in NY
Legal business name
VICTORIA VAMOS, NURSE PRACTITIONER IN FAMILY HEALTH, P.C.
Doing business as
Long Island Medical and Spa
Practice address
751 Coates Ave
Suite 31
Holbrook, NY 11741-6039
Phone
(631) 580-0000
Fax
(631) 580-0001
NPI assigned
Aug 4, 2015
Last updated
Aug 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Ms. Victoria Vamos, F.N.P.NPI 1083669915
Title
Medical Director
Phone
(631) 580-0000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SF0001X F333441 NY Primary

Addresses

Primary practice location

751 Coates Ave
Suite 31
Holbrook, NY 11741-6039

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
02633829MedicaidNY

Other names 1

  • Long Island Medical and Spa Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151029002034 NY Part B Supplier - Clinic/Group Practice 0244540433 Receives reassigned benefits from 1 practitioner
Practice locations: Holbrook, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2100422Victoria Vamos,Nurse Practitioner in Family Health751 Coates Avenue, Suite 31, Holbrook, NY 11741Certificate of waiverAug 13, 2027

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1104202993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 COATES AVE",
            "address_2": "SUITE 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",
            "address_2": "SUITE 31",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117416039",
            "telephone_number": "631-580-0000",
            "fax_number": "631-580-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA VAMOS, NURSE PRACTITIONER IN FAMILY HEALTH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "VAMOS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "631-580-0000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "F.N.P."
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "NY",
            "license": "F333441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02633829",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island Medical and Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.