Individual provider Active NPI

Carmine Vacchio, RPA-C

  • Physician Assistant
  • Garden City, NY
National Provider Identifier
1962478545
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009896 Issued in NY
Practice address
520 Franklin Ave
Suite 229
Garden City, NY 11530-5801
Phone
(516) 746-1227
Fax
(516) 746-4024
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009896 NY Primary

Addresses

Primary practice location

520 Franklin Ave
Suite 229
Garden City, NY 11530-5801

Mailing address

520 Franklin Ave
Suite 229
Garden City, NY 11530-5801
Phone (516) 746-1227

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041113000289 NY Practitioner - Physician Assistant 6002870607 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Island Dermatology PLLCGroup PAC ID 1759656374, 5 clinicians

Practice addresses (Care Compare)

1615 Northern Blvd
Suite 400
Manhasset, NY 11030-3033
Phone (516) 472-7546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1962478545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 FRANKLIN AVE",
            "address_2": "SUITE 229",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305801",
            "telephone_number": "516-746-1227",
            "fax_number": "516-746-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 FRANKLIN AVE",
            "address_2": "SUITE 229",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305801",
            "telephone_number": "516-746-1227",
            "fax_number": "516-746-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCHIO",
        "first_name": "CARMINE",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.