Vestal Healthcare, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

VESTAL HEALTHCARE, LLC

Practice address

929 Sunrise Hwy
Bay Shore, NY 11706-5907

Phone

(631) 224-8500

Fax

(631) 224-8503

NPI assigned

Nov 13, 2014

Organization subpart

No

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

Authorized official

Name

Mark E. Caputo

Title

Member

Phone

(206) 816-6505

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Long Island Bay Shore Dialysis Center Doing business as

Locations

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1447656756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 SUNRISE HWY",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065907",
            "telephone_number": "631-224-8500",
            "fax_number": "631-224-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 SUNRISE HWY",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065907",
            "telephone_number": "631-224-8500",
            "fax_number": "631-224-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VESTAL HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-13",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "CAPUTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "206-816-6505"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04240997",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island Bay Shore Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Veneziano, PT, DPT, OCS
• Rigoberto Ventura, PA-C
• Kendra Marie Verderosa
• Elizebeth Shibbu Verghese, RN,MSN,ANP-C
• Alyssa Verron, OTR/L
• Peter Vigliotta, LCSW
• Lisa Marie Vintaloro, OT
• Parsla Vintere, PH.D.
• Debra A Viola, LMSW
• Kyle Viola

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.