Organization Active NPI

Cardiology PC

  • Cardiovascular Disease Physician
  • Hartford, CT
National Provider Identifier
1003922287
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
027525 Issued in CT
Legal business name
CARDIOLOGY PC
Practice address
100 Retreat Ave
Suite 811
Hartford, CT 06106-2563
Phone
(860) 522-5712
Fax
(860) 520-4270
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James E Kallal, MD
Title
Physician President
Phone
(860) 522-5712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 027525 CT Primary

Addresses

Primary practice location

100 Retreat Ave
Suite 811
Hartford, CT 06106-2563

Mailing address

100 Retreat Ave
Suite 811
Hartford, CT 06106-2563
Phone (860) 522-5712

Other identifiers 3

IdentifierTypeStateIssuer
004052098MedicaidCT
604855OtherTUFTS
CM3450OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

100 Retreat Ave
Ste 811
Hartford, CT 06106
Phone (860) 522-5712

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1003922287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE",
            "address_2": "SUITE 811",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062563",
            "telephone_number": "860-522-5712",
            "fax_number": "860-520-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RETREAT AVE",
            "address_2": "SUITE 811",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062563",
            "telephone_number": "860-522-5712",
            "fax_number": "860-520-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "KALLAL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN PRESIDENT",
        "authorized_official_telephone_number": "860-522-5712",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "027525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004052098",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "604855",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM3450",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.