Individual provider Active NPI

Anthony V. Deiorio, MD

  • Family Medicine Physician
  • Utica, NY
National Provider Identifier
1780636910
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
093023-1 Issued in NY
Practice address
1427 Genesee St
Utica, NY 13501-4343
Phone
(315) 738-1428
Fax
(315) 738-1461
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 093023-1 NY Primary

Addresses

Primary practice location

1427 Genesee St
Utica, NY 13501-4343

Mailing address

1020 Mary St
Utica, NY 13501-1930
Phone (315) 724-6907

Other identifiers 1

IdentifierTypeStateIssuer
00474180MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
093023-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physicians Urgent Care PLLC Family Medicine PastSince May 1, 2001 Accepting new patients
John J. Costello, Jr, DO, PLLC Past Accepting new patients
Samson Pachikara MD PC Family Medicine Past Accepting new patients

Organizations & group practices 3

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1780636910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 MARY ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135011930",
            "telephone_number": "315-724-6907",
            "fax_number": "315-733-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135014343",
            "telephone_number": "315-738-1428",
            "fax_number": "315-738-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIORIO",
        "first_name": "ANTHONY",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "093023-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00474180",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.