Individual provider Active NPI

Eric C Vacco, PAC

  • Surgical Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1831439520
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5324 Issued in AZ
Practice address
3126 N Civic Center PLZ
Scottsdale, AZ 85251-6912
Phone
(480) 874-2040
Fax
(480) 874-2041
NPI assigned
Feb 18, 2013
Last updated
May 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5324 AZ Primary

Addresses

Primary practice location

3126 N Civic Center PLZ
Scottsdale, AZ 85251-6912

Mailing address

3126 N Civic Center PLZ
Scottsdale, AZ 85251-6912
Phone (480) 874-2040

Other identifiers 1

IdentifierTypeStateIssuer
793139MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20130312000213 AZ Practitioner - Physician Assistant 2668627977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sonoran Orthopaedic Trauma SurgeonsGroup PAC ID 5991735979, 29 clinicians

Practice addresses (Care Compare)

3126 N Civic Ctr PLZ
Scottsdale, AZ 85251-6912
Phone (480) 874-2040

3501 N Scottsdale Rd
Suite 136
Scottsdale, AZ 85251-5649
Phone (480) 874-2040

702 E Bell Rd
Suite 117
Phoenix, AZ 85022-6648
Phone (480) 874-2040

7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone (623) 434-6102

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5324AZMDSurgical Physician Assistant

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

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": "1361145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1831439520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 N CIVIC CENTER PLZ",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516912",
            "telephone_number": "480-874-2040",
            "fax_number": "480-874-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3126 N CIVIC CENTER PLZ",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516912",
            "telephone_number": "480-874-2040",
            "fax_number": "480-874-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCO",
        "first_name": "ERIC",
        "middle_name": "C",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-18",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "5324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "793139",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.