Individual provider Active NPI

Nicholas Justin Vaccari, M.D.

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Brooklyn, NY
National Provider Identifier
1194993881
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
License
247484 Issued in NY
Practice address
506 6TH St
Brooklyn, NY 11215-3609
Phone
(718) 780-5040
NPI assigned
Feb 14, 2008
Last updated
Mar 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 247484 NY
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 247484 NY
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 247484 NY Primary

Addresses

Primary practice location

506 6TH St
Brooklyn, NY 11215-3609

Mailing address

PO Box 5450
New York, NY 10087-5450
Phone (718) 622-2608

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080827000004 NY Practitioner - Undersea and Hyperbaric MedicinePractitioner - Emergency Medicine 1850466830 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
247484NYMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC Current Accepting new patients
Kings Physician Services, PC Emergency Medicine CurrentSince Mar 5, 2021 Accepting new patients
Interfaith Emergency Medicine, P.C. Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Jun 24, 2023 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Jun 24, 2023 Accepting new patients

Locations

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: niv9014@direct.nyp.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1194993881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5450",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100875450",
            "telephone_number": "718-622-2608",
            "fax_number": "718-622-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCARI",
        "first_name": "NICHOLAS",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-14",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "247484",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "247484",
            "primary": false
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "NY",
            "license": "247484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.