Look up the most recent NPI and PECOS records

Asa Viccellio

Emergency Medicine

Allopathic & Osteopathic Physicians

University Hospital, L4, Stony Brook, NY 11794-0001

PECOS Enrollment

Based on the most recent information from CMS, provider Asa Viccellio is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1659316750
Provider Type
Individual
Full Name
Viccellio, Asa
Title
Dr.

Credential
M.D.
Gender
Male
Enumeration Date
6/20/2006
Last Updated
7/8/2007

Contact Information

Practice Location

University Hospital, L4, Stony Brook, NY 11794-0001

(631) 444-2499

Unlisted Fax

Mailing Location

PO Box 1559, Stony Brook, NY 11790-0989

(631) 444-2499

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 137862 New York

Provider Identifiers

ID	Description	Issuer
ID 4300208	Description Other	Issuer AETNA New York
ID 00744490	Description Medicaid	Issuer Unlisted New York
ID 06F45	Description Other	Issuer EMPIRE BC.BS New York

Asa Viccellio

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Hodson, Benjamin Richard

Hwang, Taemin

Conrad, Cara

Chale, Stuart

Patel, Jiten

Singer, Adam

Scott, Hayley Morgan

Buttar, Simran

Khwaja, Sayed M.

Leibowitz, Jillian Ashley