VITASTAT MEDICAL PLLC
NPI 1811232770
Clinic/Center - Medical Specialty in Astoria, NY
About Vitastat Medical Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VITASTAT MEDICAL PLLC (NPI 1811232770) is a healthcare organization registered as a medical specialty in Astoria, New York and active in the NPI registry since December 2012. The organization holds a CLIA Waiver certificate valid through July 8, 2027 and lists Ken Truong, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vitastat Medical Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Vitastat Medical PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 33D2061692
Vitastat Medical PLLC · Astoria, NYFrequently 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 Vitastat Medical PLLC's NPI number?
The NPI number for Vitastat Medical PLLC is 1811232770. It was assigned to this organization in the NPPES registry on December 4, 2012.
Where is Vitastat Medical PLLC located?
Vitastat Medical PLLC is located at 2322 Broadway, Astoria, NY 11106. The listed phone number is (917) 300-8296.
What is Vitastat Medical PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.
Is Vitastat Medical PLLC enrolled in Medicare?
Yes. Vitastat Medical PLLC is registered in the Medicare PECOS enrollment system.
When is Vitastat Medical PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Vitastat Medical PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Vitastat Medical PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Vitastat Medical PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D2061692) is associated with this NPI, valid through July 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Vitastat Medical PLLC was last updated on December 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Vitastat Medical Pllc · NPI 1811232770
Medical Specialty organization in Astoria, New York. Organization record, active in the CMS NPPES registry since December 4, 2012.
## Identity
- **NPI:** 1811232770 (Entity type: Organization)
- **Enumerated:** December 4, 2012
- **Primary specialty:** Clinic/Center - Medical Specialty · taxonomy 261QM2500X
- **Organization subpart:** No
- **Authorized official:** Ken Truong, MANAGER
## Practice location
- **Address:** 2322 BROADWAY, Astoria, NY 11106-4196
- **Phone:** (917) 300-8296 · **Fax:** (917) 300-8296
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 4, 2012
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1811232770) · Data from the CMS NPPES public registry.