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DR. JAMES M VLASSIS DDS
NPI 1417094392
Dentist - Periodontics in Fayetteville, NY

Active since January 31, 2007Opted out of Medicare · through Aug 18, 2026
100 N BURDICK ST, FAYETTEVILLE, NY 13066(315) 637-0777(315) 637-2337 Get Directions Write a Review

NPPES record last updated: July 29, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. James M Vlassis Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAMES M VLASSIS DDS (NPI 1417094392) is an individual periodontics provider in Fayetteville, New York, licensed in New York (042985-1) and active in the NPI registry since January 2007. He has opted out of Medicare through August 18, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1417094392
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. JAMES M VLASSISCredential: DDS
Location Address100 N BURDICK STFayetteville, NY 13066-1319
Mailing Address100 N Burdick St, Po Box 296Fayetteville, NY 13066-1319 · (315) 637-0777 · Fax (315) 637-2337
Phone(315) 637-0777
Fax(315) 637-2337
Sole ProprietorYes
Enumeration DateJanuary 31, 2007
Last NPPES UpdateJuly 29, 2014
✔ NPI 1417094392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in NY · 042985-1
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
100 N BURDICK ST, Fayetteville, NY 13066
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Dr. James M Vlassis Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 18, 2016 through August 18, 2026.

Opt-Out Effective DateAugust 18, 2016
Opt-Out In Effect ThroughAugust 18, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Vlassis's NPI number?

The NPI number for James Vlassis is 1417094392. It was assigned to this individual provider in the NPPES registry on January 31, 2007.

Where is James Vlassis located?

James Vlassis practices at 100 N Burdick St, Fayetteville, NY 13066. The listed phone number is (315) 637-0777.

What is James Vlassis's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is James Vlassis enrolled in Medicare?

No. James Vlassis has opted out of Medicare through August 18, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for James Vlassis was last updated on July 29, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.