Individual provider Active NPI

Anthony Consolazio, MD

  • Family Medicine Physician
  • Vestal, NY
National Provider Identifier
1811984479
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
230312 Issued in NY
Practice address
4417 Vestal Parkway East
Suite 101
Vestal, NY 13850-3556
Phone
(607) 729-2144
Fax
(607) 729-2145
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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 230312 NY Primary

Addresses

Primary practice location

4417 Vestal Parkway East
Suite 101
Vestal, NY 13850-3556

Mailing address

33 Lewis Rd
2ND FL
Binghamton, NY 13905
Phone (607) 729-8156

Other identifiers 1

IdentifierTypeStateIssuer
02492933MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040323000255 NY Practitioner - Family Practice 9830080530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Health Services Hospitals, Inc.Group PAC ID 5193610533, 471 clinicians

Practice addresses (Care Compare)

1302 E Main St
Endicott, NY 13760-5430
Phone (607) 754-2323

4417 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 770-7365

4433 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 771-2220

507 Main St
Johnson City, NY 13790-1810
Phone (607) 763-8008

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

  • United Health Services Hospitals, Inc Hospital, Binghamton, NY, CCN 330394

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230312NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC CurrentSince Nov 10, 2003 Accepting new patients
United Medical Associates, P.C. CurrentSince Nov 10, 2003 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Dec 17, 2013 Accepting new patients

Locations

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156

4417 Vestal Pkwy E
Ste 101
Vestal, NY 13850
Phone (607) 729-2144

4417 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 729-2144

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.

Hospital & facility affiliations 1

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1811984479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD",
            "address_2": "2ND FL",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-729-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 VESTAL PARKWAY EAST",
            "address_2": "SUITE 101",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503556",
            "telephone_number": "607-729-2144",
            "fax_number": "607-729-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSOLAZIO",
        "first_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "230312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02492933",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.