Individual provider Active NPI

Manuel Vazquez-Senior, MD

  • Anesthesiology Physician
  • Massena, NY
National Provider Identifier
1134190481
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
173889 Issued in NY
Practice address
1 Hospital Dr
Massena, NY 13662-1056
Phone
(315) 764-1711
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 173889 NY Primary

Addresses

Primary practice location

1 Hospital Dr
Massena, NY 13662-1056

Mailing address

202 Taughannock Blvd
PO Box 366
Ithaca, NY 14850-3328
Phone (607) 277-4035

Other identifiers 1

IdentifierTypeStateIssuer
02097794MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506001705 NY Practitioner - Anesthesiology 3274522198 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Apr 20, 2018 Accepting new patients
Upstate Anesthesia Services, P.C. Anesthesiology CurrentSince Jan 8, 2021 Accepting new patients
Endoscopy Center of Long Island LLC CurrentSince Jun 1, 2015 Accepting new patients
Liberty Endoscopy, LLC Anesthesiology CurrentSince Jan 24, 2018 Accepting new patients
Advantagecare Physicians PC CurrentSince Apr 20, 2018 Accepting new patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Feb 5, 2022 Accepting new patients
Queens Endoscopy ASC, LLC CurrentSince Feb 11, 2018 Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

17660 Union Tpke
Fresh Meadows, NY 11366
Phone (212) 774-2474

711 Stewart Ave
Ste 114
Garden City, NY 11530
Phone (516) 227-3254

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

156 William St
Fl 4
New York, NY 10038
Phone (646) 215-2244

215 E 95th St
New York, NY 10128
Phone (212) 423-3111

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

Networks

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

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 8

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1134190481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 TAUGHANNOCK BLVD",
            "address_2": "PO BOX 366",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503328",
            "telephone_number": "607-277-4035",
            "fax_number": "607-277-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621056",
            "telephone_number": "315-764-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ-SENIOR",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "173889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02097794",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massena, NY

Sources for this page

Verify at the official NPI Registry.