Organization Active NPI

Iacobucci Internal Medicine PLLC

  • Internal Medicine Physician
  • Victor, NY
National Provider Identifier
1376323766
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IACOBUCCI INTERNAL MEDICINE PLLC
Practice address
7255 State Route 96 Ste 210
Victor, NY 14564-9009
Phone
(585) 205-8330
NPI assigned
Oct 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Authorized official

Name
Dr. James J Iacobucci, MDNPI 1700818945
Title
Physician / Owner
Phone
(858) 205-8330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

7255 State Route 96 Ste 210
Victor, NY 14564-9009

Mailing address

7255 State Route 96 Ste 210
Victor, NY 14564-9009
Phone (585) 205-8330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240105001632 NY Part B Supplier - Clinic/Group Practice 6002267804 Receives reassigned benefits from 1 practitioner
Practice locations: Victor, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2293775Iacobucci Internal Medicine PLLC7255 State Route 96, Suite 210, Victor, NY 14564Certificate of waiverNov 14, 2027

National Provider Directory

National Provider Directory

Locations

7255 State Route 96
Ste 210
Victor, NY 14564
Phone (585) 205-8330

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1376323766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7255 STATE ROUTE 96 STE 210",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649009",
            "telephone_number": "585-205-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7255 STATE ROUTE 96 STE 210",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649009",
            "telephone_number": "585-205-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IACOBUCCI INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "IACOBUCCI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "858-205-8330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.