NPIMap

Organization Active NPI

Excel Urgent Care of Nesconset, PLLC

  • Urgent Care Clinic/Center
  • Nesconset, NY
National Provider Identifier
1851679252
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
EXCEL URGENT CARE OF NESCONSET, PLLC
Practice address
465 Smithtown Blvd
Nesconset, NY 11767-2421
Phone
(613) 676-6700
NPI assigned
Aug 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Anthony R Ruvo, MDNPI 1972628014
Title
Authorized Member
Phone
(845) 565-3700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

465 Smithtown Blvd
Nesconset, NY 11767-2421

Mailing address

484 Temple Hill Rd
Suite 104
New Windsor, NY 12553-5557
Phone (845) 565-3700

Other identifiers 3

IdentifierTypeStateIssuer
PAC835COtherNYGHI
03845136MedicaidNY
934719POtherHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110901000410 NY Part B Supplier - Clinic/Group Practice 5092985986 Receives reassigned benefits from 59 practitioners
Practice locations: Nesconset, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2026445Excel Urgent Care of Nesconset, PLLC465 Smithtown Boulevard, Nesconset, NY 11767Certificate of waiverJun 29, 2027

National Provider Directory

National Provider Directory

Locations

465 Smithtown Blvd
Nesconset, NY 11767
Phone (631) 676-6700

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1851679252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 TEMPLE HILL RD",
            "address_2": "SUITE 104",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535557",
            "telephone_number": "845-565-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SMITHTOWN BLVD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672421",
            "telephone_number": "613-676-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL URGENT CARE OF NESCONSET, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "RUVO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "AUTHORIZED MEMBER",
        "authorized_official_telephone_number": "845-565-3700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "PAC835C",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03845136",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "934719P",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.