Individual provider Active NPI

William M Vacca, M.D.

  • Cardiovascular Disease Physician
  • Schenectady, NY
National Provider Identifier
1306854187
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
124483 Issued in NY
Practice address
2546 Balltown Rd
Suite 203
Schenectady, NY 12309-1079
Phone
(518) 377-8198
Fax
(518) 377-0620
NPI assigned
Aug 4, 2006
Last updated
Feb 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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 124483 NY Primary

Addresses

Primary practice location

2546 Balltown Rd
Suite 203
Schenectady, NY 12309-1079

Mailing address

2546 Balltown Rd
Suite 203
Schenectady, NY 12309-1079
Phone (518) 377-8198

Other identifiers 1

IdentifierTypeStateIssuer
00775053MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124483NYMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1306854187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 BALLTOWN RD",
            "address_2": "SUITE 203",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123091079",
            "telephone_number": "518-377-8198",
            "fax_number": "518-377-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 BALLTOWN RD",
            "address_2": "SUITE 203",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123091079",
            "telephone_number": "518-377-8198",
            "fax_number": "518-377-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCA",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "124483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00775053",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.