Gregory Michael Vallecorsa, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

057400-1 Issued in NY

Practice address

4 Sunset Dr
Latham, NY 12110-2104

Phone

(518) 785-5100

NPI assigned

Sep 2, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gvallecorsa856745@direct.trinity-health.org

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.

• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357

  Dentist

  Medicare reassignment NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  NPD
• David J. Vallecorsa DDS PLLC

  • General Practice Dentistry
  • Latham, NY
  • NPI 1043045461
  NPD (past)

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

{
    "created_epoch": "1378080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1174957641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CAVALIER WAY",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SUNSET DR",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102104",
            "telephone_number": "518-785-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLECORSA",
        "first_name": "GREGORY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-02",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057400-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William A Uhl, D.C.
• United Seating and Mobility LLC
• Maya Valentin, FNP
• Elizabeth Mary Valk, FNP-C
• David J Vallecorsa, DDS
• Jonathan David Vallecorsa
• Kim Stuart Van Der Veer, DC, CCSP
• Hoyte T Van Der Zee, M.D.
• Lucy Van Ness, RN
• Nancy Vanallen

• Dentist in Latham, NY
• Providers in Latham, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.

Verify at the official NPI Registry.