Organization Active NPI

Sottile & Megna MD PC

  • Gastroenterology Physician
  • Staten Island, NY
National Provider Identifier
1508846296
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SOTTILE & MEGNA MD PC
Practice address
360 Edison St
Staten Island, NY 10306
Phone
(718) 351-6377
Fax
(718) 980-7341
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Authorized official

Name
Mr. Vincent M Sottile, MD
Title
President
Phone
(718) 351-6389

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

360 Edison St
Staten Island, NY 10306

Mailing address

360 Edison St
Staten Island, NY 10306
Phone (718) 351-6377

Other identifiers 1

IdentifierTypeStateIssuer
C13128OtherNYRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001890 NY Part B Supplier - Clinic/Group Practice 2264323013 Receives reassigned benefits from 9 practitioners
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Locations

360 Edison St
Ste 1
Staten Island, NY 10306

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1508846296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10306",
            "telephone_number": "718-351-6377",
            "fax_number": "718-980-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10306",
            "telephone_number": "718-351-6377",
            "fax_number": "718-980-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOTTILE & MEGNA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "SOTTILE",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-351-6389",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "C13128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.