Individual provider Active NPI

Vito Anthony Racanelli, D.D.S.

  • Dentist
  • Thornwood, NY
National Provider Identifier
1184811309
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
041676 Issued in NY
Practice address
870 Franklin Ave
Thornwood, NY 10594-1403
Phone
(914) 747-4212
Fax
(914) 747-9336
NPI assigned
Oct 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 041676 NY Primary

Addresses

Primary practice location

870 Franklin Ave
Thornwood, NY 10594-1403

Mailing address

870 Franklin Ave
Thornwood, NY 10594-1403
Phone (914) 747-4212

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160427000245 NY Order and Referring Only - DentistPractitioner - Dentist 3375842339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041676NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1184811309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 FRANKLIN AVE",
            "city": "THORNWOOD",
            "state": "NY",
            "postal_code": "105941403",
            "telephone_number": "914-747-4212",
            "fax_number": "914-747-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 FRANKLIN AVE",
            "city": "THORNWOOD",
            "state": "NY",
            "postal_code": "105941403",
            "telephone_number": "914-747-4212",
            "fax_number": "914-747-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACANELLI",
        "first_name": "VITO",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "041676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornwood, NY

Sources for this page

Verify at the official NPI Registry.