DR. VINCENT JAMES ZIZZA III D.O.
NPI 1528085289
Urology in Warwick, RI

NPI Status: Active since July 17, 2006

Contact Information

400 BALD HILL RD
WARWICK, RI
ZIP 02886
Phone: (401) 739-2984
Fax: (401) 739-0867

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  • Individual
  • Male
  • Years of Experience 34
  • Urology
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About VINCENT ZIZZA

This page provides the complete NPI Profile along with additional information for Vincent Zizza, a provider established in Warwick, Rhode Island with a medical specialization in Urology and more than 34 years of experience. He graduated from University Of New England, College Of Osteo Medicine in 1992. The healthcare provider is registered in the NPI registry with number 1528085289 assigned on July 2006. The practitioner's primary taxonomy code is 208800000X with license number DO00487 (RI). The provider is registered as an individual and his NPI record was last updated 14 years ago.

NPI
1528085289
Provider Name
DR. VINCENT JAMES ZIZZA III D.O.
Gender
Male
Entity Type
Individual
Location Address
400 BALD HILL RD WARWICK, RI 02886
Location Phone
(401) 739-2984
Location Fax
(401) 739-0867
Mailing Address
176 TOLL GATE ROAD SUITE 301 WARWICK, RI 02886
Mailing Phone
(401) 739-2984
Mailing Fax
(401) 739-0867
Medical School Name
UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Graduation Year
1992
Is Sole Proprietor?
Yes
Enumeration Date
07-17-2006
Last Update Date
11-20-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Urology

Taxonomy Code
208800000X
Type
Allopathic & Osteopathic Physicians
License No.
DO00487
License State
RI
Taxonomy Description
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1174400000XOther Service Providers

Specialist

DO487 (RI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
7716215OTHER (01)RIAETNA
349006065MEDICARE PIN (08)RI 
DN3002OTHER (01)RIRAILROAD MEDICARE
349021255MEDICARE UPIN (02)RI 
G17239MEDICARE UPIN (02)RI 
2969061OTHER (01)RIUNITED HEALTHCARE
8177408002OTHER (01)RICIGNA
AA38818OTHER (01)RIHARVARD PILGRIM HEALTH CARE
1805526OTHER (01)RIUNITED HEALTHCARE
10246OTHER (01)RINEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND
794230OTHER (01)RITUFTS HEALTH PLAN
TC72651MEDICAID (05)RI 
402643OTHER (01)RIBLUE CROSS & BLUE SHIELD OF RHODE ISLAND

Medicare Participation & PECOS Enrollment Status

Vincent Zizza is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Vincent Zizza is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1456439298

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20080602000886

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $33.54 for a new patient copayment and $18.23 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 02886 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $134.17
  • Minimum New Patient Price $58.57
  • Maximum New Patient Price $177.03
  • Average New Patient Copayment $33.54
  • Minimum New Patient Copayment $14.64
  • Maximum New Patient Copayment $44.25

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $72.93
  • Minimum Established Patient Price $18.92
  • Maximum Established Patient Price $144.38
  • Average Established Patient Copayment $18.23
  • Minimum Established Patient Copayment $4.73
  • Maximum Established Patient Copayment $36.09

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1528085289, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
2
Doubled → 4
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
8
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
2
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 5 → 10 → 1 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 4 + 8 + 0 + 8 + 1 + 0 + 2 + 1 + 6 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1528085289.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Allergy & Immunology (Allergy)
400 BALD HILL RD, STE 527
WARWICK, RI 02886
Internal Medicine
400 BALD HILL RD, STE 520
WARWICK, RI 02886
Internal Medicine
400 BALD HILL RD, STE 520
WARWICK, RI 02886
Family Medicine
400 BALD HILL RD
WARWICK, RI 02886
Obstetrics & Gynecology (Gynecology)
400 BALD HILL RD, SUITE 508
WARWICK, RI 02886
Nurse Practitioner
400 BALD HILL RD, SUITE 526
WARWICK, RI 02886
Family Medicine
400 BALD HILL RD
WARWICK, RI 02886
Registered Nurse (Diabetes Educator)
400 BALD HILL RD, SUITE 530
WARWICK, RI 02886
Internal Medicine (Cardiovascular Disease)
400 BALD HILL RD, SUITE 530
WARWICK, RI 02886
Physical Therapist
400 BALD HILL RD, SUITE 502
WARWICK, RI 02886
Dentist (General Practice)
400 BALD HILL RD, SUIT 522
WARWICK, RI 02886
Social Worker
400 BALD HILL RD, SUITE 510
WARWICK, RI 02886
Clinical Nurse Specialist (Psychiatric/Mental Health)
400 BALD HILL RD, SUITE 510
WARWICK, RI 02886
Dentist (General Practice)
400 BALD HILL RD, SUITE 522
WARWICK, RI 02886
Dentist (General Practice)
400 BALD HILL RD, SUITE 522
WARWICK, RI 02886
Optometrist
400 BALD HILL RD, SUITE 163
WARWICK, RI 02886
Social Worker (Clinical)
400 BALD HILL RD, SUITE 530
WARWICK, RI 02886
Allergy & Immunology (Allergy)
400 BALD HILL RD, SUITE 527
WARWICK, RI 02886
Counselor (Mental Health)
400 BALD HILL RD
WARWICK, RI 02886
Dentist (General Practice)
400 BALD HILL RD, SUITE #522
WARWICK, RI 02886

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1528085289, enumerated as an "individual" on July 17, 2006.

The provider is located at 400 BALD HILL RD WARWICK, RI 02886 and the phone number is (401) 739-2984.

Urology with taxonomy code 208800000X.

The provider might be accepting Accepts: Aetna, Medicare, Medicaid, Railroad Medicare,. Please consult your insurance carrier or call the provider to verify.