Anzhelika Vaccaro, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

252029 Issued in NY

Practice address

125 Oakland Ave
Suite 101
Port Jefferson, NY 11777-2130

Phone

(631) 828-7100

Fax

(631) 828-7171

NPI assigned

Sep 15, 2008

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

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

State University of New York Downstate Medical Center, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ophthalmic Consultants of Long IslandGroup PAC ID 8022909076, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: anzhelika.vaccaro.p1@direct.ocli.nextgenshare.com

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.

• Ophthalmic Consultants of Long Island

  • Ophthalmology Physician
  • Rockville Centre, NY
  • NPI 1285675660
  Medicare reassignment Care Compare group NPD
• Ophthalmic Consultants of Long Island

  • Ophthalmology Physician
  • Stony Brook, NY
  • NPI 1245271600
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1114176278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302136",
            "telephone_number": "516-804-5200",
            "fax_number": "516-240-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 OAKLAND AVE",
            "address_2": "SUITE 101",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772130",
            "telephone_number": "631-828-7100",
            "fax_number": "631-828-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCARO",
        "first_name": "ANZHELIKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "252029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03137102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen A Tyler, LCSW
• Ezinne K Uduma
• Janta D Ukrani, MD
• Darcy K Upton, PT RN
• Urological Associates of Li, PC
• Mary Jane Vacirca, MS, PT
• John Mark Vanburik
• Regina Catherine Varacchi, RN
• Varicose Vein Medical Office PC
• Varicose Vein Medical Office PC

• Ophthalmology Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.
• 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.