NPIMap

Individual provider Active NPI

Adam Paul Vasconcellos, M.D.

  • Otolaryngology Physician
  • Wyomissing, PA
National Provider Identifier
1386939023
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD459611 Issued in PA
Practice address
985 Berkshire Blvd Ste 101
Wyomissing, PA 19610-1268
Phone
(610) 374-5599
Fax
(610) 375-1262
NPI assigned
Jun 10, 2011
Last updated
Mar 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 247774 MA
Otolaryngology Physician 207Y00000X MD459611 PA Primary

Addresses

Primary practice location

985 Berkshire Blvd Ste 101
Wyomissing, PA 19610-1268

Mailing address

985 Berkshire Blvd Ste 101
Wyomissing, PA 19610-1268
Phone (610) 374-5599

Other identifiers 1

IdentifierTypeStateIssuer
1032662510002MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avasconcellos@ent985.medentdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170705000136 PA Practitioner - OtolaryngologyPractitioner - Internal Medicine 2860625894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Warren Alpert Medical School of Brown University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Head and Neck Specialists, PCGroup PAC ID 3173500451, 11 clinicians

Practice addresses (Care Compare)

985 Berkshire Blvd
Suite 101
Wyomissing, PA 19610-1268
Phone (610) 374-5599

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.73 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
72.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247774MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Head & Neck Specialists PC Otolaryngology CurrentSince Jul 1, 2019 Accepting new patients

Locations

985 Berkshire Blvd
Ste 101
Wyomissing, PA 19610
Phone (215) 374-5599

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1386939023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 BERKSHIRE BLVD STE 101",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101268",
            "telephone_number": "610-374-5599",
            "fax_number": "610-375-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 BERKSHIRE BLVD STE 101",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101268",
            "telephone_number": "610-374-5599",
            "fax_number": "610-375-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASCONCELLOS",
        "first_name": "ADAM",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "247774",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD459611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032662510002",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avasconcellos@ent985.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIE",
            "address_1": "985 Berkshire Blvd Ste 101",
            "city": "Wyomissing",
            "state": "PA",
            "country_code": "US",
            "postal_code": "196101268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.