Vincent P Anzalone, MD
Individual provider Active NPI Internal Medicine Physician · Massapequa, NY
NPI 1811085392 · NPPES record last updated Feb 19, 2021
Key facts
- NPI
- 1811085392
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 157952 (NY)
- Practice address
- 847 N Broadway
Suite 103
Massapequa, NY 11758-2373 - Phone
- (516) 798-0441
- Fax
- (516) 797-8044
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101025000238 | NY | Practitioner - Internal Medicine | 8224162060 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 157952 | NY | MD | Internal Medicine Physician |
| 187592 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Internal Medicine | Current |
Accepting new patients |
| New York University | Internal Medicine | Current |
Accepting new patients |
Locations
340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064
847 N Broadway
Ste 103
Massapequa, NY 11758
Phone (516) 798-0441
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 157952 | NY | Yes |
Addresses
Primary practice location
847 N Broadway
Suite 103
Massapequa, NY 11758-2373
Mailing address
79 Aster Strret
Massapequa Park, NY 11762-2373
Phone (519) 798-0093
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01112165 | Medicaid | NY |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | vanzalone230527@nyumc.direct-ci.com |
Other providers in Massapequa, NY
- Ambulatory Medical Services
- Yarrell Afi Ametewee
- Katherine A Andreski
- Kelly Ann Antimisiaris
- Rachel Lindsay Antonucci
- Yessica Aparicio Chicas
- Scott D Apgar
- Padmaja Aradhya
- Joan Marie Ardito
- Julianna Ardolina
All providers in Massapequa, NY · Internal Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.