| Dr Vito Fodera, MD | |
|
763 Larkfield Rd, Commack, NY 11725-3131 | |
| (631) 489-5000 | |
| (631) 858-1990 |
| Full Name | Dr Vito Fodera |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 18 Years |
| Location | 763 Larkfield Rd, Commack, New York |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376818039 | NPI | - | NPPES |
| A400090538 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085N0700X | Radiology - Neuroradiology | 60264556 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence Saint Joseph Medical Ctr | Burbank, CA | Hospital |
| Antelope Valley Hospital | Lancaster, CA | Hospital |
| Glendale Mem Hospital & Hlth Center | Glendale, CA | Hospital |
| Northridge Hospital Medical Center | Northridge, CA | Hospital |
| Valley Presbyterian Hospital | Van nuys, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Golden State Imaging Associates Inc | 1254761315 | 194 |
| Renaissance Imaging Medical Associates Inc | 7315841756 | 119 |
| Renaissance Imaging Medical Associates Inc | 7315841756 | 119 |
| Renaissance Imaging Medical Associates Inc | 7315841756 | 119 |
| Renaissance Imaging Medical Associates Inc | 7315841756 | 119 |
| Entity Name | Renaissance Imaging Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487608931 PECOS PAC ID: 7315841756 Enrollment ID: O20031126000257 |
| Entity Name | Southern Inyo Healthcare District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831128602 PECOS PAC ID: 7911816731 Enrollment ID: O20040317000188 |
| Entity Name | Golden State Imaging Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144872052 PECOS PAC ID: 1254761315 Enrollment ID: O20200414001788 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Vito Fodera, MD 763 Larkfield Rd, Commack, NY 11725-3131 Ph: (631) 489-5000 | Dr Vito Fodera, MD 763 Larkfield Rd, Commack, NY 11725-3131 Ph: (631) 489-5000 |
Daphna Y Gelblum, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 650 Commack Rd, Commack, NY 11725 Phone: 212-639-2000 | |
Mark J Bluth, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 650 Commack Rd, Commack, NY 11725 Phone: 646-227-3813 | |
Dr. Vinodkumar Velayudhan, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 763 Larkfield Road, Commack, NY 11725 Phone: 631-489-5000 |