Individual provider Active NPI

Vincent S Ladelia, MD

  • Cardiovascular Disease Physician
  • Pine City, NY
National Provider Identifier
1205938263
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
157419-1 Issued in NY
Practice address
1243 Pennsylvania Ave
Pine City, NY 14871-9230
Phone
(570) 734-6281
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 157419-1 NY Primary

Addresses

Primary practice location

1243 Pennsylvania Ave
Pine City, NY 14871-9230

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other identifiers 1

IdentifierTypeStateIssuer
01027590MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080325000162 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 5395734206 Reassigns benefits to 1 organization
I20130528000441 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 5395734206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
New York Medical College, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

1 Guthrie Dr
Corning, NY 14830-3696
Phone (607) 973-7200

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

1336 Cedar St
Elmira, NY 14904-2951
Phone (607) 734-3929

134 Homer Ave
Cortland, NY 13045-1206
Phone (607) 756-3500

3 Guthrie Dr
Corning, NY 14830-3696
Phone (607) 973-8000

31 Arnot Rd
A
Horseheads, NY 14845-8533
Phone (607) 795-5100

3344 Chambers Rd
Horseheads, NY 14845-1403
Phone (607) 795-5100

9768 Liberty Dr
Painted Post, NY 14870-9094
Phone (607) 937-4900

One Guthrie SQ
Sayre, PA 18840-1625

One Guthrie Square
Sayre, PA 18840-1625

Hospital & facility affiliations

  • Corning Hospital Hospital, Corning, NY, CCN 330277
  • Robert Packer Hospital Hospital, Sayre, PA, CCN 390079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
157419-1NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. Cardiovascular Disease CurrentSince May 17, 2013 Accepting new patients
Guthrie Medical Group, P.C. Cardiovascular Disease CurrentSince Jun 1, 2013 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince May 17, 2013 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: vladelia45669@direct-guthrie.org

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1205938263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 PENNSYLVANIA AVE",
            "city": "PINE CITY",
            "state": "NY",
            "postal_code": "148719230",
            "telephone_number": "570-734-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADELIA",
        "first_name": "VINCENT",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "157419-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01027590",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine City, NY

Sources for this page

Verify at the official NPI Registry.