Individual provider Active NPI

Nicola Corvaja, M.D.

  • Interventional Cardiology Physician
  • New York, NY
National Provider Identifier
1003988643
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036162088 Issued in IL
Practice address
161 Fort Washington Ave
New York, NY 10032-3729
Phone
(212) 342-3616
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 002451 NY
Cardiovascular Disease Physician 207RC0000X 043618 CT
Interventional Cardiology Physician 207RI0011X DR.0042596 CO
Interventional Cardiology Physician 207RI0011X 043618 CT
Interventional Cardiology Physician 207RI0011X 036162088 IL Primary
Interventional Cardiology Physician 207RI0011X 002451 NY

Addresses

Primary practice location

161 Fort Washington Ave
New York, NY 10032-3729

Mailing address

1980 Crompond Rd Ste 3R
Cortlandt Manor, NY 10567-4144
Phone (914) 734-3550

Other practice location 1

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7000

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
Direct Messaging Address nic9023@direct.nyp.org Direct
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY, IL, MT4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20051215000111 CT Practitioner - Interventional CardiologyPractitioner - Other (Physician)Practitioner - Cardiovascular Disease (Cardiology) 7214958453 Practice locations: Stamford, CT
I20060327000006 NY Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 7214958453 Reassigns benefits to 1 organization
I20230323001981 IL Practitioner - Interventional Radiology 7214958453 Reassigns benefits to 1 organization
I20260511003362 MT Practitioner - Interventional Cardiology 7214958453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Falls Clinic LLCGroup PAC ID 8325944499, 73 clinicians
The Westchester Medical Practice PCGroup PAC ID 9335238732, 198 clinicians
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

1400 29TH St S
Great Falls, MT 59405-5315
Phone (406) 454-2171

1980 Crompond Rd
Cortlandt Manor, NY 10567-4144
Phone (914) 737-9000

2300 N Rockton Ave
Rockford, IL 61103-3619
Phone (815) 971-2000

3000 15TH Ave S
Great Falls, MT 59405-5240
Phone (406) 454-2171

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-2000

Hospital & facility affiliations

  • Javon Bea Hospital Hospital, Rockford, IL, CCN 140239
  • Great Falls Clinic Hospital Hospital, Great Falls, MT, CCN 270086

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
002451NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jan 20, 2023 Accepting new patients
The Westchester Medical Practice, PC CurrentSince Mar 14, 2022 Accepting new patients
The Westchester Medical Practice, PC CurrentSince Mar 14, 2022 Accepting new patients
Trustees Columbia University City Ny Center Interventional Vascular TH Interventional Cardiology Past Accepting new patients
Heart Physicians, P.C. Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

1980 Crompond Rd
Cortlandt Mnr, NY 10567
Phone (914) 734-3600

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: nic9023@direct.nyp.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1003988643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 CROMPOND RD STE 3R",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105674144",
            "telephone_number": "914-734-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-342-3616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7000",
            "fax_number": "815-968-4795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORVAJA",
        "first_name": "NICOLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "002451",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "043618",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CO",
            "license": "DR.0042596",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CT",
            "license": "043618",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036162088",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "002451",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "1980 Crompond Rd",
            "city": "Cortlandt Manor",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105674144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nic9023@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "1980 Crompond Rd",
            "city": "Cortlandt Manor",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105674144",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "1980 Crompond Rd",
            "city": "Cortlandt Manor",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105674144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.