Nicholas Caccavo, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

126427 Issued in NY

Practice address

100 Clinton St
Suite 20
Brooklyn, NY 11201-4362

Phone

(718) 625-8700

Fax

(718) 625-7536

NPI assigned

Sep 11, 2006

Last updated

Nov 22, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1326142506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CLINTON ST",
            "address_2": "SUITE 20",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11201",
            "telephone_number": "718-643-6005",
            "fax_number": "718-625-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CLINTON ST",
            "address_2": "SUITE 20",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014362",
            "telephone_number": "718-625-8700",
            "fax_number": "718-625-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCAVO",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "126427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01591937",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cabs Nursing Home Company, Inc.
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• Stephanie Marie Cacace
• Cacanct LLC
• Annamaria Caccamo
• Stacey A Cacciola, D.O.
• Jessica Cacere
• Stephanie Caceres-Yagual, LMHCD
• Cindy Ines Caceres
• Sonny Caceres, MD

• Cardiovascular Disease Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.