Individual provider Active NPI

Vincent Campasano, MD

  • Emergency Medicine Physician
  • Lindenhurst, NY
National Provider Identifier
1881781979
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
228987 Issued in NY
Practice address
656 North Wellwood Ave Suite G & H
Premiere Care
Lindenhurst, NY 11757
Phone
(631) 225-4227
Fax
(631) 225-4229
NPI assigned
Oct 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 228987 NY Primary
Emergency Medicine Physician 207P00000X 25MA09619200 NJ

Addresses

Primary practice location

656 North Wellwood Ave Suite G & H
Premiere Care
Lindenhurst, NY 11757

Mailing address

656 North Wellwood Avenue Suite G & H
Premier Care
Lindenhurst, NY 11757
Phone (631) 225-4227

Other practice location 1

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 277-8880

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
I20041223000129 NY Practitioner - Emergency Medicine 5496713398 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Medical of New York PLLC CurrentSince Aug 3, 2022 Accepting new patients
Weill Medical College of Cornell Emergency Medicine Past Accepting new patients

Locations

255 Executive Dr
Ste 210B
Plainview, NY 11803
Phone (516) 687-9563

10 Maple St
Prt Washingtn, NY 11050
Phone (917) 746-5942

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1881781979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 NORTH WELLWOOD AVENUE SUITE G & H",
            "address_2": "PREMIER CARE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "11757",
            "telephone_number": "631-225-4227",
            "fax_number": "631-225-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 NORTH WELLWOOD AVE SUITE G & H",
            "address_2": "PREMIERE CARE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "11757",
            "telephone_number": "631-225-4227",
            "fax_number": "631-225-4229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Diamond Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Berkeley Heights",
            "state": "NJ",
            "postal_code": "079222104",
            "country_code": "US",
            "telephone_number": "908-277-8880",
            "fax_number": "908-277-8796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPASANO",
        "first_name": "VINCENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "228987",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA09619200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

Verify at the official NPI Registry.