Individual provider Active NPI

Cary Frank Vastola, D.O.

  • Family Medicine Physician
  • Williamsville, NY
National Provider Identifier
1619901170
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
142631 Issued in NY
Practice address
30 N Union Rd
Williamsville, NY 14221-5367
Phone
(716) 839-8000
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 142631 NY Primary

Addresses

Primary practice location

30 N Union Rd
Williamsville, NY 14221-5367

Mailing address

30 N Union Rd
Williamsville, NY 14221-5367
Phone (716) 839-8000

Other identifiers 3

IdentifierTypeStateIssuer
6405734OtherNYIHA PROVIDER ID
00010182702OtherNYUNIVERA PROVIDER ID
000508092002OtherNYBLUECROSS BLUESHIELD ID

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051209000631 NY Practitioner - Family Practice 6901827641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care of Western New York LLP Family Medicine CurrentSince Apr 29, 2002 Accepting new patients
Digestive Health Physicians, P.C. Past Accepting new patients

Locations

30 N Union Rd
Williamsville, NY 14221
Phone (716) 633-6363

30 N Union Rd
Ste 102
Williamsville, NY 14221
Phone (716) 839-8000

Organizations & group practices 2

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1619901170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N UNION RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215367",
            "telephone_number": "716-839-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N UNION RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215367",
            "telephone_number": "716-839-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASTOLA",
        "first_name": "CARY",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "142631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA PROVIDER ID",
            "identifier": "6405734",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA PROVIDER ID",
            "identifier": "00010182702",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD ID",
            "identifier": "000508092002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.