Active NPI
Gina Genoveffa Vitiello, MD
- Psychiatry Physician
- Randolph, MA
National Provider Identifier
1932135639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 159786
- Practice address
- 47 Concetta Sass Dr
Randolph, MA 02368-1812 - Phone
- (781) 767-3276
- Fax
- (781) 767-3276
- NPI assigned
- Jun 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | |||
| Psychiatry Physician | 2084P0800X | 159786 | MA | Primary |
Addresses
Primary practice location
47 Concetta Sass Dr
Randolph, MA 02368-1812
Mailing address
680 Centre St
Attn: Provider Enrollment
Brockton, MA 02302-3308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 159786 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588636800000",
"number": "1932135639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 CENTRE ST",
"address_2": "ATTN: PROVIDER ENROLLMENT",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023023308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 CONCETTA SASS DR",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023681812",
"telephone_number": "781-767-3276",
"fax_number": "781-767-3276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITIELLO",
"first_name": "GINA",
"middle_name": "GENOVEFFA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-24",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "159786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randolph, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.