NPIMap

Individual provider Active NPI

Joseph P Vickaryous, D.O.

  • General Practice Physician
  • Marco Island, FL
National Provider Identifier
1750475240
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS9338 Issued in FL
Practice address
531 Bald Eagle Dr
Marco Island, FL 34145-2700
Phone
(239) 393-2000
Fax
(239) 393-0355
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS9338 FL
General Practice Physician 208D00000X OS9338 FL Primary

Addresses

Primary practice location

531 Bald Eagle Dr
Marco Island, FL 34145-2700

Mailing address

531 Bald Eagle Dr
Marco Island, FL 34145-2700
Phone (239) 393-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100120000596 FL Practitioner - Family Practice 5395887913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

531 Bald Eagle Dr
Marco Island, FL 34145-2700
Phone 2393932000101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions139

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Vickaryous D.O. P.a. Family Medicine CurrentSince Jan 20, 2010 Accepting new patients

Locations

531 Bald Eagle Dr
Marco Island, FL 34145
Phone (239) 393-2000

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: drvickaryous@direct.meditouchehr.com

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1750475240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 BALD EAGLE DR",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341452700",
            "telephone_number": "239-393-2000",
            "fax_number": "239-393-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 BALD EAGLE DR",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341452700",
            "telephone_number": "239-393-2000",
            "fax_number": "239-393-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKARYOUS",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS9338",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS9338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marco Island, FL

Sources for this page

Verify at the official NPI Registry.