Individual provider Active NPI

Albert B Accettola Jr., MD

  • Orthopaedic Surgery Physician
  • Staten Island, NY
National Provider Identifier
1972584696
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
1263871 Issued in NY
Practice address
3311 Hylan Blvd
Staten Island, NY 10306-3688
Phone
(718) 667-7500
Fax
(718) 351-1580
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 1263871 NY Primary

Addresses

Primary practice location

3311 Hylan Blvd
Staten Island, NY 10306-3688

Mailing address

2535 Arthur Kill Rd
Staten Island, NY 10309-1207
Phone (718) 448-3210

Other identifiers 1

IdentifierTypeStateIssuer
01695981MedicaidNY

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

LicenseStateTypeSpecialty
1263871NYMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1972584696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 ARTHUR KILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091207",
            "telephone_number": "718-448-3210",
            "fax_number": "718-967-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063688",
            "telephone_number": "718-667-7500",
            "fax_number": "718-351-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACCETTOLA",
        "first_name": "ALBERT",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "1263871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01695981",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.