Individual provider Active NPI

Gerard F Vitale, MD

  • Specialist
  • Glen Cove, NY
National Provider Identifier
1396801759
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
154983 Issued in NY
Practice address
1 School Street
Suite 205
Glen Cove, NY 11542
Phone
(516) 759-5559
Fax
(516) 759-1671
NPI assigned
Dec 29, 2006
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 154983 NY Primary

Addresses

Primary practice location

1 School Street
Suite 205
Glen Cove, NY 11542

Mailing address

1 School Street
Suite 205
Glen Cove, NY 11542
Phone (516) 759-5559

Other identifiers 1

IdentifierTypeStateIssuer
01088288MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110218000128 NY Practitioner - Vascular Surgery 9234310665 Practice locations: Glen Cove, NY

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
State University of New York at Buffalo School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 School St
Suite 205
Glen Cove, NY 11542-2529
Phone (516) 759-5559

Merit-based Incentive Payment System (MIPS)

Final score
64.23 of 100Reported as individual
Quality
28.46
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1017

National Provider Directory

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

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1396801759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SCHOOL STREET",
            "address_2": "SUITE 205",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "11542",
            "telephone_number": "516-759-5559",
            "fax_number": "516-759-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SCHOOL STREET",
            "address_2": "SUITE 205",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "11542",
            "telephone_number": "516-759-5559",
            "fax_number": "516-759-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "GERARD",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "154983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01088288",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.