NPIMap

Organization Active NPI

Pacific Cardiology Consultants LLC

  • Interventional Cardiology Physician
  • Tamuning, GU
National Provider Identifier
1013278936
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
PACIFIC CARDIOLOGY CONSULTANTS LLC
Practice address
633 Gov Carlos G Camacho Rd
Suite 210, Guam Medical Plaza
Tamuning, GU 96913
Phone
(671) 649-1001
Fax
(671) 649-1002
NPI assigned
Jun 7, 2012
Last updated
May 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Authorized official

Name
Terri Case
Title
RCM
Phone
(671) 488-7775

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X Primary
Nuclear Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207UN0901X

Addresses

Primary practice location

633 Gov Carlos G Camacho Rd
Suite 210, Guam Medical Plaza
Tamuning, GU 96913

Mailing address

633 Gov Carlos G Camacho Rd
Suite 210, Guam Medical Plaza
Tamuning, GU 96913-3194
Phone (671) 488-7775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120905000136 GU Part B Supplier - Clinic/Group Practice 0547417131 Receives reassigned benefits from 8 practitioners
Practice locations: Tamuning, GU

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1013278936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 GOV CARLOS G CAMACHO RD",
            "address_2": "SUITE 210, GUAM MEDICAL PLAZA",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133194",
            "telephone_number": "671-488-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GOV CARLOS G CAMACHO RD",
            "address_2": "SUITE 210, GUAM MEDICAL PLAZA",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-649-1001",
            "fax_number": "671-649-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CARDIOLOGY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "CASE",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "RCM",
        "authorized_official_telephone_number": "671-488-7775"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.