Individual provider Active NPI

Victor Bello, PA

  • Specialist
  • Manorville, NY
National Provider Identifier
1356636468
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
014617-1 Issued in NY
Practice address
3 Surrey LN
Manorville, NY 11949-2536
Phone
(631) 926-7792
NPI assigned
Jun 16, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 014617-1 NY Primary

Addresses

Primary practice location

3 Surrey LN
Manorville, NY 11949-2536

Mailing address

3 Surrey LN
Manorville, NY 11949-2536
Phone (631) 926-7792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110829000015 NY Practitioner - Physician Assistant 5294905378 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Suffolk HospitalGroup PAC ID 4981508082, 94 clinicians
Peconic Bay Primary Medical CareGroup PAC ID 7113817602, 72 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6101

34 Commerce Ave
Riverhead, NY 11901-3118
Phone (631) 727-1600

496 County Rd
111 BLDG B
Manorville, NY 11949-3386
Phone (631) 405-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014617-1NYMDSpecialist
014617NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Aug 28, 2019 Accepting new patients
New York University CurrentSince May 10, 2019 Accepting new patients
Central Suffolk Hosptial CurrentSince Jul 20, 2011 Accepting new patients
True North Medical Group PC CurrentSince Jan 4, 2022 Accepting new patients
True North Medical Group PC CurrentSince Jan 4, 2022 Accepting new patients
New York University CurrentSince May 10, 2019 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

300 Community Dr
Plandome, NY 11030

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

Networks

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

Interoperability endpoints

  • Direct secure messaging: vbello69994@northwell.direct-ci.com
  • Direct secure messaging: victorbello@nslijmedgr.allscriptsdirect.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1356636468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SURREY LN",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492536",
            "telephone_number": "631-926-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SURREY LN",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492536",
            "telephone_number": "631-926-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLO",
        "first_name": "VICTOR",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "014617-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manorville, NY

Sources for this page

Verify at the official NPI Registry.