NPIMap

Individual provider Active NPI

James J Vacek, MD

  • Family Medicine Physician
  • Gloversville, NY
National Provider Identifier
1780698290
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
138653 Issued in NY
Practice address
99 East State Street
Mab-GR01
Gloversville, NY 12078
Phone
(518) 775-4201
Fax
(518) 775-4225
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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 138653 NY Primary

Addresses

Primary practice location

99 East State Street
Mab-GR01
Gloversville, NY 12078

Mailing address

99 East State Street
PO Box 1250
Gloversville, NY 12078
Phone (518) 775-4201

Other identifiers 4

IdentifierTypeStateIssuer
10026183OtherNYCDPHP
00617152MedicaidNY
950995OtherNYMVP HEALTHPLAN
000401141002OtherNYBSH NE NY

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
138653NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan Littauer Hospital Association Past Accepting new patients
Nathan Littauer Hospital Association Past Accepting new patients

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1780698290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EAST STATE STREET",
            "address_2": "PO BOX 1250",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "12078",
            "telephone_number": "518-775-4201",
            "fax_number": "518-775-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 EAST STATE STREET",
            "address_2": "MAB-GR01",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "12078",
            "telephone_number": "518-775-4201",
            "fax_number": "518-775-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACEK",
        "first_name": "JAMES",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "138653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10026183",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00617152",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHPLAN",
            "identifier": "950995",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSH NE NY",
            "identifier": "000401141002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloversville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.