Glenn Charles Vitale, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

P00345 Issued in CT

Practice address

385 Main St
Suite 10
West Haven, CT 06516-4312

Phone

(203) 933-8606

Fax

(203) 932-9571

NPI assigned

Jul 22, 2005

Last updated

Nov 20, 2009By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: glennvitale@ctpod.directglo.com

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.

• Connecticut Podiatry Group, P.C.

  • Foot Surgery Podiatrist
  • West Haven, CT
  • NPI 1912076886
  Medicare reassignment
• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138
  NPD (past)
• Saint Raphael Healthcare System Affiliated Physicians Inc

  dba Affiliated Physicians of Saint Raphael

  • Neurology Physician
  • New Haven, CT
  • NPI 1063744001
  NPD (past)

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1730189556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90A BEACH AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064608060",
            "telephone_number": "203-877-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 MAIN ST",
            "address_2": "SUITE 10",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164312",
            "telephone_number": "203-933-8606",
            "fax_number": "203-932-9571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "GLENN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "P00345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004060828",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veteran's Affairs
• Veterans Administration
• Veterans Affairs
• Veterans Healthcare System
• Nicholas Andrew Vissicchio, PH.D.
• Miriam Vitale, PA-C
• Dolores Vojvoda, M.D.
• Darren C. Volpe, MD
• Donna Marie Voytek
• Van Vu

• Foot & Ankle Surgery Podiatrist in West Haven, CT
• Providers in West Haven, CT by specialty
• Foot & Ankle Surgery Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.