Mary Ann Vaccarello, M.D.

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

ME 0056044 Issued in FL

Practice address

927 45TH St Ste 206
Mangonia Park, FL 33407-2450

Phone

(561) 844-8354

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Pediatric MedicineAlso: Endocrinology

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kidz Medical Services IncGroup PAC ID 3678536240, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.vaccarello.1@27004.direct.athenahealth.com
• Direct secure messaging: mvaccarello21031@jupitermedicalcenter.direct-ci.com
• Direct secure messaging: maryvaccarello@kms.allscriptsdirect.net

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.

• Kidz Medical Services, Inc

  • Children's Hospital
  • Coral Gables, FL
  • NPI 1366408379

  Pediatric Endocrinology

  Medicare reassignment Care Compare group NPD
• Kidz Medical Services, Inc

  • Pediatric Nephrology Physician
  • South Miami, FL
  • NPI 1730637927
  NPD

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1285789594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-611-1515",
            "fax_number": "305-662-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 45TH ST STE 206",
            "city": "MANGONIA PARK",
            "state": "FL",
            "postal_code": "334072450",
            "telephone_number": "561-844-8354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Burns Rd",
            "address_2": "200",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334104325",
            "country_code": "US",
            "telephone_number": "561-624-1985",
            "fax_number": "561-624-7255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VACCARELLO",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME 0056044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379171800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "ME 0056044",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Thomas, MD, RD
• Diane Antoinette Thompson, M.D.
• Youlanda Thompson, MS, LMHC
• Lindsay R Tiggis, RN, BSN, MSN, APRN
• Jonathan Lee Turkish, MD
• Christine Marie Vanbasten, LMHC
• Eric Verfaillie, PA-C, MMS
• Walgreen Co
• West PL Behavioral Services
• Benjamin Dominic Westerhaus, MD

• Pediatric Endocrinology Physician in Mangonia Park, FL
• Providers in Mangonia Park, FL by specialty
• Pediatric Endocrinology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.