Individual provider Active NPI

Vincent Palmieri

  • Pediatric Cardiology Physician
  • Glendale, AZ
National Provider Identifier
1366983702
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
71998 Issued in AZ
Practice address
6524 W Sack Dr Ste 240
Glendale, AZ 85308-7719
Phone
(602) 933-3363
NPI assigned
Mar 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 86104 GA
Pediatric Cardiology Physician 2080P0202X 71998 AZ Primary

Addresses

Primary practice location

6524 W Sack Dr Ste 240
Glendale, AZ 85308-7719

Mailing address

2108 E Thomas Rd
Phoenix, AZ 85016-7761
Phone (602) 933-3124

Other practice location 1

1405 Clifton Rd NE
Atlanta, GA 30322-3052
Phone (404) 778-1440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20240830001047 AZ Practitioner - Cardiovascular Disease (Cardiology) 5092254383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Medical University of South Carolina College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

Hospital & facility affiliations

  • Phoenix Children'S Hospital Hospital, Phoenix, AZ, CCN 033302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71998AZMDPediatric Cardiology Physician
86104GAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Aug 1, 2024 Accepting new patients
Phoenix Children'S Hospital CurrentSince Oct 27, 2024 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Aug 1, 2024 Accepting new patients

Locations

1665 N Avondale Blvd
Avondale, AZ 85392
Phone (602) 933-0005

6524 W Sack Dr
Ste 240
Glendale, AZ 85308
Phone (602) 933-3363

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2108 E Thomas Rd
Phoenix, AZ 85016

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1366983702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167761",
            "telephone_number": "602-933-3124",
            "fax_number": "404-778-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6524 W SACK DR STE 240",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087719",
            "telephone_number": "602-933-3363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303223052",
            "country_code": "US",
            "telephone_number": "404-778-1440",
            "fax_number": "404-778-1401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMIERI",
        "first_name": "VINCENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-18",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "86104",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "AZ",
            "license": "71998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.