Active NPI
David P Vigeant, P.A.
- Physician Assistant
- Antwerp, NY
National Provider Identifier
1962484675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004813
- Practice address
- 40 Main St
Antwerp, NY 13608-4164 - Phone
- (315) 659-8993
- Fax
- (315) 659-2418
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004813 | NY | Primary |
Addresses
Primary practice location
40 Main St
Antwerp, NY 13608-4164
Mailing address
77 W Barney St
Gouverneur, NY 13642-1040
Phone (315) 535-9202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004813 | Other | NY | LICENSE |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4813 | NY | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward John Noble Hospital of Gouverneur Ny | Past | Accepting new patients | |
| Edward John Noble Hospital of Gouverneur Ny Swing Bed Unit | Past | Accepting new patients |
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.
-
- Rural Acute Care Hospital
- Gouverneur, NY
- NPI 1316940745
-
- Medicare Defined Swing Bed Hospital Unit
- Gouverneur, NY
- NPI 1215031885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1962484675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 W BARNEY ST",
"city": "GOUVERNEUR",
"state": "NY",
"postal_code": "136421040",
"telephone_number": "315-535-9202",
"fax_number": "315-535-9207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 MAIN ST",
"city": "ANTWERP",
"state": "NY",
"postal_code": "136084164",
"telephone_number": "315-659-8993",
"fax_number": "315-659-2418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIGEANT",
"first_name": "DAVID",
"middle_name": "P",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-17",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004813",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "004813",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Antwerp, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.