NPIMap

Organization Active NPI

Excel Urgent Care of Wantagh PLLC

  • Urgent Care Clinic/Center
  • Wantagh, NY
National Provider Identifier
1184067936
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
EXCEL URGENT CARE OF WANTAGH PLLC
Practice address
3430 Sunrise Hwy
Wantagh, NY 11793-4028
Phone
(516) 900-1600
NPI assigned
Apr 11, 2013
Last updated
Aug 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Authorized official

Name
Anthony R Ruvo, MDNPI 1972628014
Title
Sole Proprietor
Phone
(845) 565-3700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

3430 Sunrise Hwy
Wantagh, NY 11793-4028

Mailing address

484 Temple Hill Rd
Suite 104
New Windsor, NY 12553-5557
Phone (845) 565-3700

Other identifiers 1

IdentifierTypeStateIssuer
03868191MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131104000254 NY Part B Supplier - Clinic/Group Practice 9234364027 Receives reassigned benefits from 136 practitioners
Practice locations: Amityville, NY; Wantagh, NY; Staten Island, NY; Massapequa Park, NY; Freeport, NY; Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2061857Excel Urgent Care of Wantagh, PLLC3430 Sunrise Highway, Wantagh, NY 11793Certificate of waiverJul 7, 2027

National Provider Directory

National Provider Directory

Locations

4954 Merrick Rd
Massapequa Park, NY 11762
Phone (516) 308-7255

3894 Richmond Ave
Staten Island, NY 10312
Phone (347) 630-7985

7001 Amboy Rd
Staten Island, NY 10307
Phone (347) 838-6991

Practitioners & affiliated clinicians

Practitioners 141

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 141

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1184067936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 TEMPLE HILL RD",
            "address_2": "SUITE 104",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535557",
            "telephone_number": "845-565-3700",
            "fax_number": "845-565-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 SUNRISE HWY",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117934028",
            "telephone_number": "516-900-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL URGENT CARE OF WANTAGH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-11",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "RUVO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "845-565-3700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03868191",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.