Individual provider Active NPI

Vito Aniello Petrozzino, M.D.

  • Emergency Medicine Physician
  • Ormond Beach, FL
National Provider Identifier
1811287014
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME123472 Issued in FL
Practice address
2860 Ocean Shore Blvd
Apt 206
Ormond Beach, FL 32176-2521
Phone
(201) 787-7651
NPI assigned
Apr 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME123472 FL Primary

Addresses

Primary practice location

2860 Ocean Shore Blvd
Apt 206
Ormond Beach, FL 32176-2521

Mailing address

2860 Ocean Shore Blvd
Apt 206
Ormond Beach, FL 32176-2521
Phone (201) 787-7651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150526001711 FL Practitioner - Emergency Medicine 6800116245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York Medical College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Professionals PAGroup PAC ID 0446244362, 20 clinicians

Practice addresses (Care Compare)

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2000

Hospital & facility affiliations

  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME123472FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Professionals PA Emergency Medicine CurrentSince Jun 1, 2015 Accepting new patients

Locations

701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1811287014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 OCEAN SHORE BLVD",
            "address_2": "APT 206",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321762521",
            "telephone_number": "201-787-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 OCEAN SHORE BLVD",
            "address_2": "APT 206",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321762521",
            "telephone_number": "201-787-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROZZINO",
        "first_name": "VITO",
        "middle_name": "ANIELLO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-09",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME123472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.