Individual provider Active NPI

Vincent Anthony Vitulli

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1467938324
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022326 Issued in NY
Practice address
475 Seaview Ave
Staten Island, NY 10305
Phone
(718) 226-9000
NPI assigned
Jul 13, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022326 NY Primary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 1154654 NY

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305

Mailing address

54 Notus Ave
Staten Island, NY 10312-3123
Phone (646) 675-4390

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181109001993 NY Practitioner - Physician Assistant 0840544854 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022326NYMDPhysician Assistant
1154654NYMDPhysician Assistant

Networks

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

Interoperability endpoints

  • Direct secure messaging: vvitulli69484@northwell.direct-ci.com

Organizations & group practices 3

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": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1467938324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 NOTUS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123123",
            "telephone_number": "646-675-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITULLI",
        "first_name": "VINCENT",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022326",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "1154654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.