Vandana K Bacon, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

264564 Issued in NY

Practice address

301 Manchester Rd.
Suite 105
Poughkeepsie, NY 12603-2587

Phone

(845) 452-1700

Fax

(845) 452-1752

NPI assigned

Aug 26, 2010

Last updated

Jul 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nuvance Health Medical Practice PC

  • Internal Medicine Physician
  • Poughkeepsie, NY
  • NPI 1437358033

  Pediatrics

  Medicare reassignment NPD
• Health Quest Medical Practice, PC

  • Diagnostic Radiology Physician
  • Kingston, NY
  • NPI 1558906610
  NPD

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1356657498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MANCHESTER RD.",
            "address_2": "SUITE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032587",
            "telephone_number": "845-452-1700",
            "fax_number": "845-452-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MANCHESTER RD.",
            "address_2": "SUITE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032587",
            "telephone_number": "845-452-1700",
            "fax_number": "845-452-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "VANDANA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "264564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaheda N Azher, MD
• B & M Ambulette Inc
• Linda Babas, SLP
• Christopher J. Babb, LMSW
• Mary M. Babcock, LCSW
• Maria Badami, PA
• Samantha Badillo, CASAC-G ADVANCED
• Jose E Baez, MD
• Alan Bagun, O.D.
• Cynthia Bahret, LPN

• Pediatrics Physician in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.