Vincent Joseph Fasanello, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

170635 Issued in NY

Practice address

135 Sullys TRL
Ste 11
Pittsford, NY 14534-4564

Phone

(585) 381-1558

Fax

(585) 381-0109

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 15, 2018 through Sep 15, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rory P Houghtalen MD PLLC

  • Psychiatry Physician
  • Rochester, NY
  • NPI 1043745037
  NPD
• Genesee Valley Physical Therapy & Sports Rehab., P.C.

  • Physical Therapist
  • Rochester, NY
  • NPI 1407910953
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1902827314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SULLYS TRL",
            "address_2": "STE 11",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344564",
            "telephone_number": "585-381-1558",
            "fax_number": "585-381-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SULLYS TRL",
            "address_2": "STE 11",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344564",
            "telephone_number": "585-381-1558",
            "fax_number": "585-381-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANELLO",
        "first_name": "VINCENT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2022-10-25",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "170635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "101190EU",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "010176035",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5714454",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1745",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Fama, P.T.
• Fantuzzo Oral, Maxillofacial, and Dental Implant Surgery, PLLC
• Rachel Leah Farkas, M.D.
• Evan Schweigert Farley, LCSW
• Yoko Farmer, LCSW
• Andrea Faulkner, M.D.
• Marti Clement Fausold-Mowers, ED.D., MSW, LCSW
• Michael Shane Fauth, FNP
• Fe B Whitcomb
• Tamar Feldman, L.AC.

• Psychiatry Physician in Pittsford, NY
• Providers in Pittsford, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.