Selwyn Maurice Vickers, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18186 Issued in AL

Practice address

1275 York Ave Ste M-110
New York, NY 10065-6007

Phone

(212) 639-6561

Fax

(212) 717-3299

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, NY2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Memorial Hospital for Cancer and Allied Diseases

  • General Acute Care Hospital
  • New York, NY
  • NPI 1700887411

  Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership
• Ralph Lauren Center for Cancer Care and Prevention

  • Special Hospital
  • New York, NY
  • NPI 1770046351

  Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership
• Memorial Hospital for Cancer & Allied Diseases

  • General Acute Care Hospital
  • Basking Ridge, NJ
  • NPI 1659385474

  Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership
• Memorial Sloan Kettering Bergen

  • General Acute Care Hospital
  • Montvale, NJ
  • NPI 1841650330

  Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership
• Memorial Sloan Kettering Monmouth

  • General Acute Care Hospital
  • Middletown, NJ
  • NPI 1528428521

  Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Mskcc Surgery Group

  • Surgical Oncology Physician
  • New York, NY
  • NPI 1699766261

  Surgery

  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1215964754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE STE M-110",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-6561",
            "fax_number": "212-717-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE STE M-110",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-6561",
            "fax_number": "212-717-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "SELWYN",
        "middle_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "49253",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "AL",
            "license": "18186",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "18186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicente J Liz Defillo
• Lisa Christine Vicente, CASAC-T
• Pratya Vichetpitayapong, RN
• Monique Vickerie
• Adrienne Vickers, MD
• Carlin Borden Vickery, M.D.
• Sean M Vickery, CASAC-T
• Vicki J Levine M.D.
• A-Rian Vince Victa, RDN.CDN
• Victor Dermatology & Rejuvenation, PC

• Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.