Organization Active NPI

New Wave Cardiology PLLC

  • Specialist
  • Oakdale, NY
National Provider Identifier
1013359561
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1241551 Issued in NY
Legal business name
NEW WAVE CARDIOLOGY PLLC
Practice address
1237 Montauk Hwy
Oakdale, NY 11769-1434
Phone
(631) 615-4411
NPI assigned
Jul 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Authorized official

Name
Dr. Jeffrey Mitchel, M.D
Title
Owner
Phone
(631) 615-4411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 1241551 NY Primary

Addresses

Primary practice location

1237 Montauk Hwy
Oakdale, NY 11769-1434

Mailing address

1237 Montauk Hwy
Oakdale, NY 11769-1434
Phone (631) 615-4411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181022001797 NY Part B Supplier - Clinic/Group Practice 0840543880 Practice locations: Oakdale, NY

National Provider Directory

National Provider Directory

Locations

4232 Francis Lewis Blvd
#1
Bayside, NY 11361
Phone (718) 717-0003

11 Ralph Pl
Ste 214
Staten Island, NY 10304
Phone (718) 226-6398

Practitioners & affiliated clinicians

Practitioners 5

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": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639008000000",
    "number": "1013359561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691434",
            "telephone_number": "631-615-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691434",
            "telephone_number": "631-615-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW WAVE CARDIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "MITCHEL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-615-4411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "1241551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.