Individual provider Active NPI

Ciara Vitallo, FNP

  • Family Nurse Practitioner
  • Schenectady, NY
National Provider Identifier
1194408294
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F352293 Issued in NY
Practice address
805 Al Constantino Dr
Schenectady, NY 12306-5874
Phone
(518) 257-2163
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F352293 NY Primary

Addresses

Primary practice location

805 Al Constantino Dr
Schenectady, NY 12306-5874

Mailing address

805 Al Constantino Dr
Schenectady, NY 12306-5874
Phone (518) 257-2163

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909002620 NY Practitioner - Nurse Practitioner 1254871932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Medical Care PCGroup PAC ID 2365705696, 54 clinicians

Practice addresses (Care Compare)

165 N Village Ave
Rockville Centre, NY 11570-3701
Phone (212) 803-3339

27 New Dorp LN
Staten Island, NY 10306-2349
Phone (212) 803-3339

7600 Jericho Tpke
Woodbury, NY 11797-1728
Phone (212) 803-3339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F352293NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Medical Care PC Family CurrentSince Jul 23, 2024 Accepting new patients
Fara Stricker Family Health Nurse Practitioner, P.C. PastSince May 14, 2023 Accepting new patients

Locations

233 Union Ave
Ste 105
Holbrook, NY 11741
Phone (631) 285-7311

917 W Beech St
Long Beach, NY 11561
Phone (516) 689-7580

333 E Shore Rd
Ste 201
Manhasset, NY 11030
Phone (516) 829-3044

1991 Marcus Ave
Ste 110
New Hyde Park, NY 11042
Phone (516) 365-8086

265 Sunrise Hwy
Ste 1274
Rockville Ctr, NY 11570

165 N Village Ave
Ste 133
Rockville Ctr, NY 11570
Phone (516) 764-0879

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1194408294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 AL CONSTANTINO DR",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123065874",
            "telephone_number": "518-257-2163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 AL CONSTANTINO DR",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123065874",
            "telephone_number": "518-257-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALLO",
        "first_name": "CIARA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F352293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.