Active NPI
Salvatore J Devincenzo, MD
- Pulmonary Disease Physician
- Goshen, NY
National Provider Identifier
1154300689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 145343
- Practice address
- 70 Hatfield LN
Suite 101
Goshen, NY 10924-6734 - Phone
- (845) 294-8888
- Fax
- (845) 294-1669
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 145343 | NY | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 145343 | NY | |
| Pulmonary Disease Physician | 207RP1001X | 145343 | NY | Primary |
Addresses
Primary practice location
70 Hatfield LN
Suite 101
Goshen, NY 10924-6734
Mailing address
20 Grand Street
3Rd FL
Warwick, NY 10990-1035
Phone (845) 987-3906
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00787357 | Medicaid | NY | |
| 110035384 | Other | NY | RAILROAD MEDICARE PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145343 | NY | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goshen Medical Associates PC | Pulmonary Disease | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pulmonary Disease Physician
- Goshen, NY
- NPI 1689620973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503273600000",
"number": "1154300689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 GRAND STREET",
"address_2": "3RD FL",
"city": "WARWICK",
"state": "NY",
"postal_code": "109901035",
"telephone_number": "845-987-3906",
"fax_number": "845-987-5979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 HATFIELD LN",
"address_2": "SUITE 101",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109246734",
"telephone_number": "845-294-8888",
"fax_number": "845-294-1669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVINCENZO",
"first_name": "SALVATORE",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2017-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "145343",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NY",
"license": "145343",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "145343",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00787357",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PIN",
"identifier": "110035384",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goshen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.