Active NPI
I. Michael Vella, M.D.
- Orthopaedic Surgery Physician
- De Witt, NY
National Provider Identifier
1518924224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 147849
- Practice address
- 5719 Widewaters Pkwy
De Witt, NY 13214-1880 - Phone
- (315) 251-3100
- Fax
- (315) 449-9923
- NPI assigned
- Apr 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 147849 | NY | Primary |
Addresses
Primary practice location
5719 Widewaters Pkwy
De Witt, NY 13214-1880
Mailing address
5719 Widewaters Pkwy
Syracuse, NY 13214-1880
Phone (315) 251-3100
NPI Registry JSON
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518924224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5719 WIDEWATERS PKWY",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132141880",
"telephone_number": "315-251-3100",
"fax_number": "315-449-9923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5719 WIDEWATERS PKWY",
"city": "DE WITT",
"state": "NY",
"postal_code": "132141880",
"telephone_number": "315-251-3100",
"fax_number": "315-449-9923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELLA",
"first_name": "I.",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NY",
"license": "147849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in De Witt, NY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.