Active NPI
John Scott Vasquez, PA-C
- Physician Assistant
- New York, NY
National Provider Identifier
1568839884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 018991
- Practice address
- 170 William St
New York, NY 10038-2612 - Phone
- (212) 312-5920
- NPI assigned
- Aug 24, 2015
- Last updated
- Aug 24, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 018991 | NY | Primary |
Addresses
Primary practice location
170 William St
New York, NY 10038-2612
Mailing address
40 E 3Rd St
Huntington Station, NY 11746-1420
Phone (631) 882-4478
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- State University of New York at Stony Brook, School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750
101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580
75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018991 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stony Brook Internists, University Faculty Practice Corporation | Current | Accepting new patients | |
| John T. Mather Memorial Hospital | Current | Accepting new patients | |
| John T. Mather Memorial Hospital | Past | Accepting new patients |
Locations
75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320
100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Critical Care Medicine (Internal Medicine) Physician
- Port Jefferson, NY
- NPI 1467249334
-
- Cardiac Rehabilitation Registered Nurse
- Stony Brook, NY
- NPI 1295778371
-
- Internal Medicine Physician
- West Islip, NY
- NPI 1124184544
-
- Psychiatry Physician
- Port Jefferson Station, NY
- NPI 1376642371
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Jefferson, NY
- NPI 1093718728
-
dba Stony Brook Southampton Hospital
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440374400000",
"number": "1568839884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 E 3RD ST",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117461420",
"telephone_number": "631-882-4478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 WILLIAM ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100382612",
"telephone_number": "212-312-5920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASQUEZ",
"first_name": "JOHN",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-24",
"last_updated": "2015-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "018991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.