MRS. AUDREY VIZZACCARO (P.A.-C.) – Medical Physician Assistant, NPI 1982878609

MRS. AUDREY VIZZACCARO (P.A.-C.) is a healthcare provider. based in Lake orion, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.-C.. They hold a License No. 5601003044 (MI). The NPI Number for MRS. AUDREY VIZZACCARO (P.A.-C.) is 1982878609

Main info

Female
Sole Proprietor
28 Years Of Experience
Accepts Medicare Assignment
Name
MRS. AUDREY VIZZACCARO (P.A.-C.)
NPI
1982878609
Phone
(248) 814-7546
Address
1261 SOUTH LAPEER RD
Enumeration Date
14 April 2008
Last Update Date
14 April 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2488147546
Graduation Year
1998 (28 years ago)
PAC ID
4284000506
Group Practice PAC ID
2961437744
Professional Enrollment ID
I20221011002627
Address ID
MI483601419LA1261XRDXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

Provider Addresses for MRS. AUDREY VIZZACCARO (P.A.-C.)

  • 1261 SOUTH LAPEER RD

    STE 201

    LAKE ORION, MI 48360

    Phone: (248) 814-7546

    Fax: (248) 814-8900

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 42 Open Payments records for all available years, with a total value of $1,283.

Total Amount is formed as General ($1,283) + Research ($0) + Ownership ($0) = $1,283.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Janssen Biotech, Inc. ($296).

Total Amount

$1,283

General + Research + Ownership

Payments

42

Total payment records

General Amount

$1,283

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-10-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221011002627IPhysician AssistantMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48360)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961437744View full group profile
NameSpecialtyState
D E R M A T O L O G YMI

Reviews

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Frequently asked questions

Is there an official ID for MRS. AUDREY VIZZACCARO (P.A.-C.) in U.S. healthcare records?
The official identifier for MRS. AUDREY VIZZACCARO (P.A.-C.) is NPI 1982878609.
Is there an active status for MRS. AUDREY VIZZACCARO (P.A.-C.)?
For scheduling context, MRS. AUDREY VIZZACCARO (P.A.-C.) is shown as active in the registry.
How would a patient describe MRS. AUDREY VIZZACCARO (P.A.-C.)'s focus?
For MRS. AUDREY VIZZACCARO (P.A.-C.), the primary taxonomy reads as Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MRS. AUDREY VIZZACCARO (P.A.-C.)?
Travel planning: use Lake Orion, Michigan as the reference point for MRS. AUDREY VIZZACCARO (P.A.-C.), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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