John Cacace, MD
Individual provider Active NPI Emergency Medicine Physician · Bridgeport, CT
NPI 1891714689 · NPPES record last updated Apr 30, 2008
Key facts
- NPI
- 1891714689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 29217 (SC)
- Practice address
- 267 Grant St
Bridgeport, CT 06610-2805 - Phone
- (203) 384-4490
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Icahn School of Medicine at Mount Sinai, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Acs Primary Care Physicians - Southeast PC
Practice addresses (Care Compare)
10 E Hospital St
Manning, SC 29102-3153
Phone (803) 433-3000
Hospital & facility affiliations
- McLeod Health Clarendon
- McLeod Medical Center - Dillon
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071002000063 | SC | Practitioner - Emergency Medicine | 9032204300 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036537 | CT | MD | Personal Emergency Response Attendant |
| 29217 | SC | MD | Emergency Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Emergency Response Attendant | 146D00000X | 036537 | CT | |
| Emergency Medicine Physician | 207P00000X | 29217 | SC | Yes |
Addresses
Primary practice location
267 Grant St
Bridgeport, CT 06610-2805
Mailing address
617 Nautilus Drive
Murrells Inlet, SC 29576
Phone (203) 500-0969
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 292178 | Medicaid | SC |
Other providers in Bridgeport, CT
- Jasmine Vanessa Bustillo
- Christine G Butler
- Sabrina Butler
- William R Butler
- Eleanor Marie Cabrera Aguirre
- Paige Cackovic
- Alex Scott Cadan
- Rachel Cadan
- Concetta Marie Cadella
- Cara Elizabeth Cahill
All providers in Bridgeport, CT · Emergency Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.