Active NPI
Carmine L Tiso, DDS
- Dentist
- Clarence, NY
National Provider Identifier
1174652994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 036870
- Practice address
- 9530 Main St
Clarence, NY 14031 - Phone
- (716) 759-2255
- Fax
- (716) 759-1318
- NPI assigned
- Mar 5, 2007
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 036870 | NY | Primary |
Addresses
Primary practice location
9530 Main St
Clarence, NY 14031
Mailing address
9530 Main St
Clarence, NY 14031
Phone (716) 759-2255
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4000196 | Other | NY | INDEPENDENT HEALTH |
| 00072046001 | Other | NY | BLUE CROSS SHIELD |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160112002915 | NY | Order and Referring Only - Dentist | 7214239995 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174652994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9530 MAIN ST",
"city": "CLARENCE",
"state": "NY",
"postal_code": "14031",
"telephone_number": "716-759-2255",
"fax_number": "716-759-1318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9530 MAIN ST",
"city": "CLARENCE",
"state": "NY",
"postal_code": "14031",
"telephone_number": "716-759-2255",
"fax_number": "716-759-1318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TISO",
"first_name": "CARMINE",
"middle_name": "L",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "036870",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH",
"identifier": "4000196",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS SHIELD",
"identifier": "00072046001",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarence, NY
- Nicole Marie Swiatek, PT
- Telerad of Ny Account Management
- Sandra Maria Ticen, MS, LCAT, CAS
- Tina Degeorge Physical Therapist, PLLC
- Margaret M Tirado, OTR
- Joann Vattimo
- Melissa Anne Verdi, MS, RDN, CDN, CDCES
- Wal-Mart Stores East LP (Walmart Pharmacy 10-2355)
- Walgreen Co (Walgreens #11142)
- Francesca Walker, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.