Individual provider Active NPI

Rachael Vancura, M. D.

  • Pediatrics Physician
  • West Islip, NY
National Provider Identifier
1689743932
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
238778 Issued in NY
Practice address
239 Higbie LN
West Islip, NY 11795-2825
Phone
(631) 376-6000
Fax
(631) 376-6031
NPI assigned
Nov 8, 2006
Last updated
Dec 8, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 238778 NY Primary

Addresses

Primary practice location

239 Higbie LN
West Islip, NY 11795-2825

Mailing address

239 Higbie LN
West Islip, NY 11795-2825
Phone (631) 376-6000

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
I20180920000924 NY Practitioner - Pediatric Medicine 6204187875 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Arcana Mental Health LLC PastSince Feb 17, 2022 Accepting new patients
Timothy George M.D., P.C. Pediatrics Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1689743932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 HIGBIE LN",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952825",
            "telephone_number": "631-376-6000",
            "fax_number": "631-376-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 HIGBIE LN",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952825",
            "telephone_number": "631-376-6000",
            "fax_number": "631-376-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCURA",
        "first_name": "RACHAEL",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "238778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.