Brockport Vine Medical PC
NPI 1871144543 · Internal Medicine Physician · Brockport, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Brockport Vine Medical PC is a Internal Medicine Physician organization in Brockport, NY (NPI 1871144543).
Provider details
- NPI number
- 1871144543
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Alex Fahoury, Owner(585) 208-8668
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-09-24
- Last updated
- 2020-01-03
- Certified
- 2020-01-03
Frequently asked questions
- What is Brockport Vine Medical PC's NPI number?
- Brockport Vine Medical PC's National Provider Identifier (NPI) is 1871144543, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Brockport Vine Medical PC?
- Brockport Vine Medical PC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Brockport Vine Medical PC located?
- Brockport Vine Medical PC's practice location on file with NPPES is 122 West Ave Ste 6, Brockport, NY 14420-1225.
- What is Brockport Vine Medical PC's phone number?
- The practice phone number listed in the NPPES registry for Brockport Vine Medical PC is (585) 208-8668.
- Does Brockport Vine Medical PC accept Medicare?
- Brockport Vine Medical PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Brockport Vine Medical PC?
- The authorized official listed on Brockport Vine Medical PC's NPPES record is Alex Fahoury, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Brockport Vine Medical PC's NPI active?
- Yes — Brockport Vine Medical PC's NPI (1871144543) is active in the NPPES registry as of the last update on 2020-01-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.