Individual provider Active NPI

Timothy Joseph Vinciguerra, M.D.

  • Obstetrics & Gynecology Physician
  • Albany, NY
National Provider Identifier
1376530014
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
119640-1 Issued in NY
Practice address
391 Myrtle Ave Ste 200
Albany, NY 12208-3835
Phone
(518) 262-4942
Fax
(518) 262-5291
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 119640-1 NY Primary

Addresses

Primary practice location

391 Myrtle Ave Ste 200
Albany, NY 12208-3835

Mailing address

391 Myrtle Ave Ste 200
Albany, NY 12208-3835
Phone (518) 262-4942

Other identifiers 1

IdentifierTypeStateIssuer
00815009MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
119640-1NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Obstetrics & Gynecology Current Accepting new patients

Locations

16 New Scotland Ave
Fl 2
Albany, NY 12208
Phone (518) 262-4942

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

Organizations & group practices 1

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1376530014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 MYRTLE AVE STE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083835",
            "telephone_number": "518-262-4942",
            "fax_number": "518-262-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 MYRTLE AVE STE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083835",
            "telephone_number": "518-262-4942",
            "fax_number": "518-262-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCIGUERRA",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "119640-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00815009",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.