Active NPI
Albert G Caccavale, DO
- Hospitalist Physician
- Prescott, AZ
National Provider Identifier
1780670513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 1944
- Practice address
- 1003 Willow Creek Rd
Prescott, AZ 86301-1641 - Phone
- (928) 771-5420
- Fax
- (928) 771-5471
- NPI assigned
- Sep 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 47673 | CO | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 1944 | AZ | |
| Hospitalist Physician | 208M00000X | 1944 | AZ | Primary |
Addresses
Primary practice location
1003 Willow Creek Rd
Prescott, AZ 86301-1641
Mailing address
PO Box 11720
Prescott, AZ 86304-1720
Phone (928) 771-5487
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109745004 | Other | APIPA | |
| 913113200 | Medicaid | FL | |
| 29826551 | Medicaid | CO | |
| AZ0744400 | Other | BCBS | |
| 109745 | Other | AHCCCS |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1944 | AZ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519257600000",
"number": "1780670513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11720",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863041720",
"telephone_number": "928-771-5487",
"fax_number": "928-771-5471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 WILLOW CREEK RD",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011641",
"telephone_number": "928-771-5420",
"fax_number": "928-771-5471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CACCAVALE",
"first_name": "ALBERT",
"middle_name": "G",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2018-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "CO",
"license": "47673",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "AZ",
"license": "1944",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "AZ",
"license": "1944",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APIPA",
"identifier": "109745004",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "913113200",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "29826551",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "AZ0744400",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "109745",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.