Philip J. Fraccola, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

173758 Issued in NY

Practice address

5100 W Taft Rd
Suite 2a
Liverpool, NY 13088-3807

Phone

(315) 452-2555

Fax

(315) 452-2559

NPI assigned

Aug 16, 2005

Last updated

Aug 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY, FL, CA, WA4 enrollments

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 4

Specialty

Diagnostic Radiology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Advanced Radiology and Interventional Associates IncGroup PAC ID 2163816448, 99 clinicians

Radiologica IncGroup PAC ID 8820337769, 46 clinicians

Prospect Hill Radiology Group P CGroup PAC ID 6204806862, 16 clinicians

St Josephs Imaging Associates PLLCGroup PAC ID 5991775553, 16 clinicians

Mohawk Glen Radiology Associates of Cny PLLCGroup PAC ID 8224215900, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Hospital Health Center Hospital, Syracuse, NY, CCN 330140
• St Joseph's Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
• Mercy Medical Center Hospital, Merced, CA, CCN 050444
• HCA Florida Bayonet Point Hospital Hospital, Hudson, FL, CCN 100256
• HCA Florida Oak Hill Hospital Hospital, Brooksville, FL, CCN 100264

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mohawk Glen Radiology Associates of Cny PLLC

  • Diagnostic Radiology Physician
  • Rome, NY
  • NPI 1538466115
  Medicare reassignment Care Compare group NPD Authorized official
• St. Josephs Imaging Associates PLLC

  • Diagnostic Radiology Physician
  • Liverpool, NY
  • NPI 1093709180
  Medicare reassignment Care Compare group NPD
• Advanced Radiology and Interventional Associates Inc

  • Diagnostic Radiology Physician
  • Stockton, CA
  • NPI 1669123626

  FL

  Medicare reassignment Care Compare group NPD
• Mori Bean and Brooks Inc

  dba Coastal Vein Vascular Institute

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1093782070

  NY

  Medicare reassignment Care Compare group NPD
• Radiologica Inc.

  • Diagnostic Radiology Physician
  • San Andreas, CA
  • NPI 1073000105

  FL

  Medicare reassignment Care Compare group NPD
• Prospect Hill Radiology Group P C

  • Diagnostic Radiology Physician
  • Syracuse, NY
  • NPI 1235122425
  Medicare reassignment Care Compare group
• University Radiology Associates, LLP

  • Diagnostic Radiology Physician
  • Syracuse, NY
  • NPI 1215978184
  Medicare reassignment NPD
• Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1083802946

  NY

  Medicare reassignment NPD
• Southern Inyo Healthcare District

  • Critical Access Hospital
  • Lone Pine, CA
  • NPI 1831128602
  Medicare reassignment NPD
• Tra-Minw P S

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1396814166

  NY

  Medicare reassignment NPD
• Union Avenue Open MRI LLC

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1568531242

  NY

  Medicare reassignment NPD
• Adventist Health Delano

  dba Delano Regional Medical Center

  • Registered Dietitian
  • Delano, CA
  • NPI 1578798047
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation
• Dignity Health

  dba Mercy Medical Center Merced

  • General Acute Care Hospital
  • Merced, CA
  • NPI 1518018191
  Care Compare affiliation
• HCA Health Services of Florida, Inc.

  dba HCA Florida Oak Hill Hospital

  • General Acute Care Hospital
  • Brooksville, FL
  • NPI 1013961838
  Care Compare affiliation
• HCA Health Services of Florida, Inc.

  dba HCA Florida Bayonet Point Hospital

  • General Acute Care Hospital
  • Hudson, FL
  • NPI 1992759419
  Care Compare affiliation
• Port City Operating Company, LLC

  dba St. Joseph's Medical Center of Stockton

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1699767707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "address_2": "2ND FLOOR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 2A",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-452-2555",
            "fax_number": "315-452-2559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 NW 95th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331502038",
            "country_code": "US",
            "telephone_number": "305-835-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1304 Fawcett Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984021900",
            "country_code": "US",
            "telephone_number": "253-761-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRACCOLA",
        "first_name": "PHILIP",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD61497216",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME147948",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "173758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02224500",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00555500",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00555440",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01334321",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige Joan Foley, MS CF-SLP
• Jayne Marie Foote, NP
• Alan Foster, M.D.
• Jeremy Foster
• Jennifer Foxton
• Deborah Jean Freeman, NP
• Gary M Freeman, MD
• Matthew Ryan Fuller, DC, LMT
• G.R. Zaccaria & Assoc. Inc.
• Michelle M Gabay, NPP

• Diagnostic Radiology Physician in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.

Verify at the official NPI Registry.