Andrew P. Privitera, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

046561 Issued in NY

Practice address

595 Erie Ave
North Tonawanda, NY 14120-4404

Phone

(716) 693-3997

Fax

(716) 693-2808

NPI assigned

May 8, 2007

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497968341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 ERIE AVE",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204404",
            "telephone_number": "716-693-3997",
            "fax_number": "716-693-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 ERIE AVE",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141204404",
            "telephone_number": "716-693-3997",
            "fax_number": "716-693-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIVITERA",
        "first_name": "ANDREW",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01773826",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Pisarek-Freatman, MS
• Stanley Michael Piskorowski, RPH
• Joanna Pitz
• Maria Remedios Lelis Polito, AGNP
• Michele Porreca
• Tahir M Qazi, MD
• Sabrina Christine Quarantillo, FNP
• Krista Rahelich
• Charmy Rani
• Kylie Reach, RDN, CDN

• General Practice Dentistry in North Tonawanda, NY
• Providers in North Tonawanda, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.