Individual provider Active NPI

Vincent Joseph Montagnino, RPA

  • Medical Physician Assistant
  • Gloversville, NY
National Provider Identifier
1780611228
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001484 Issued in NY
Practice address
84 E. State St
St. Mary'S Hospital, Gloversville Family Health Center
Gloversville, NY 12078
Phone
(518) 773-8894
Fax
(518) 773-8125
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001484 NY Primary

Addresses

Primary practice location

84 E. State St
St. Mary'S Hospital, Gloversville Family Health Center
Gloversville, NY 12078

Mailing address

427 Guy Park Ave - Primary & Specialty Care Dept.
St. Mary'S Hospital at Amsterdam
Amsterdam, NY 12010
Phone (518) 841-7430

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060912000414 NY Practitioner - Physician Assistant 4486658192 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001484NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Healthcare CurrentSince Oct 25, 2014 Accepting new patients
St Marys Healthcare CurrentSince Oct 25, 2014 Accepting new patients

Locations

380 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 841-7415

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

84 E State St
Gloversville, NY 12078
Phone (518) 332-4336

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1780611228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 GUY PARK AVE - PRIMARY & SPECIALTY CARE DEPT.",
            "address_2": "ST. MARY'S HOSPITAL AT AMSTERDAM",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "12010",
            "telephone_number": "518-841-7430",
            "fax_number": "518-841-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 E. STATE ST",
            "address_2": "ST. MARY'S HOSPITAL, GLOVERSVILLE FAMILY HEALTH CENTER",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "12078",
            "telephone_number": "518-773-8894",
            "fax_number": "518-773-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGNINO",
        "first_name": "VINCENT",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "RPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "001484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloversville, NY

Sources for this page

Verify at the official NPI Registry.