Philip Dominic Vitticore, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

237427 Issued in NY

Practice address

400 Fort Hill Ave
Canandaigua, NY 14424-1159

Phone

(585) 393-7293

Fax

(585) 393-8375

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Ontario Neurology Associates

  • Neurology Physician
  • Canandaigua, NY
  • NPI 1376568287
  Medicare reassignment NPD

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1417969049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FORT HILL AVE",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241159",
            "telephone_number": "585-393-7293",
            "fax_number": "585-393-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FORT HILL AVE",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241159",
            "telephone_number": "585-393-7293",
            "fax_number": "585-393-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 E Main St",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Clifton Springs",
            "state": "NY",
            "postal_code": "144321224",
            "country_code": "US",
            "telephone_number": "315-462-9578",
            "fax_number": "315-462-7241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VITTICORE",
        "first_name": "PHILIP",
        "middle_name": "DOMINIC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "237427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "RB8229",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Noel Verrette, PA
• Anna Maria De Spirito Vestal
• Jayson Villeneuve
• Callie Vinci, FNP
• Stephanie Vitalone, RN
• Gregory Voci III, DDS
• Amy Nageldinger Vogan, RNFA
• Marsha Vonrhedey
• Jana L Wachsler, PSYD
• Kelesey Wage

• Neurology Physician in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.