Organization Active NPI

Concourse Cardiology Associates, P.C.

  • Cardiovascular Disease Physician
  • Bronx, NY
National Provider Identifier
1013044551
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
163921 Issued in NY
Legal business name
CONCOURSE CARDIOLOGY ASSOCIATES, P.C.
Practice address
3130 Grand Concourse
Suite 1G
Bronx, NY 10458-1213
Phone
(718) 733-5299
Fax
(718) 733-2873
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Authorized official

Name
Dr. Veena Gupta, M.D.NPI 1245332352
Title
Doctor
Phone
(718) 733-5299

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 163921 NY Primary

Addresses

Primary practice location

3130 Grand Concourse
Suite 1G
Bronx, NY 10458-1213

Mailing address

16 Fawn LN
Armonk, NY 10504-1126

Other identifiers 1

IdentifierTypeStateIssuer
011823922MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000369 NY Part B Supplier - Clinic/Group Practice 2860381001 Receives reassigned benefits from 3 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

3130 Grand Concourse
Ste 1G
Bronx, NY 10458
Phone (718) 733-5299

3130 Grand Concourse
Ste Iv
Bronx, NY 10458
Phone (718) 733-5299

Practitioners & affiliated clinicians

Practitioners 4

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": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1013044551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FAWN LN",
            "city": "ARMONK",
            "state": "NY",
            "postal_code": "105041126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 GRAND CONCOURSE",
            "address_2": "SUITE 1G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581213",
            "telephone_number": "718-733-5299",
            "fax_number": "718-733-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCOURSE CARDIOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "VEENA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "718-733-5299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "163921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011823922",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.