Individual provider Active NPI

Vincent Mule

  • Physician Assistant
  • Smithtown, NY
National Provider Identifier
1821839093
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211
Phone
(631) 543-1440
NPI assigned
Jun 3, 2024
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211

Mailing address

994 W Jericho Tpke Ste 104
Smithtown, NY 11787-3211
Phone (631) 543-1440

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250224002181 NY Practitioner - Physician Assistant 4981124765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timothy D. Groth MD PCGroup PAC ID 8921002320, 43 clinicians

Practice addresses (Care Compare)

994 W Jericho Tpke
Suite 104
Smithtown, NY 11787-3211
Phone (631) 543-1440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy D. Groth MD PC CurrentSince Jan 4, 2026 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jan 2, 2025 Accepting new patients

Locations

1500 Middle Country Rd
Centereach, NY 11720
Phone (631) 716-8758

285 Sills Rd
Bldg 9D
East Patchogue, NY 11772
Phone (631) 319-6107

285 Sills Rd
East Patchogue, NY 11772
Phone (631) 447-8300

1111 Broadhollow Rd
Ste 114
Farmingdale, NY 11735
Phone (516) 336-8659

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

81 N Broadway
Hicksville, NY 11801
Phone (516) 827-7400

300 Community Dr
Manhasset, NY 11030

184 Old Country Rd
Mineola, NY 11501
Phone (516) 294-4457

1061 N Broadway
Ste 2
North Massapequa, NY 11758
Phone (516) 420-4300

410 Hallock Ave
Port Jefferson Station, NY 11776
Phone (631) 642-1100

100 N Centre Ave
Ste 302
Rockville Centre, NY 11570

1010 Sunrise Hwy
Rockville Ctr, NY 11570
Phone (516) 377-7213

1500 William Floyd Pkwy
Ste 201
Shirley, NY 11967
Phone (631) 205-0800

994 W Jericho Tpke
Smithtown, NY 11787
Phone (631) 864-4499

994 W Jericho Tpke
Ste 104
Smithtown, NY 11787
Phone (516) 400-3595

1111 Route 110
South Farmingdale, NY 11735
Phone (267) 642-4091

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1821839093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 W JERICHO TPKE STE 104",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873211",
            "telephone_number": "631-543-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 W JERICHO TPKE STE 104",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873211",
            "telephone_number": "631-543-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULE",
        "first_name": "VINCENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.