Organization Active NPI

Varughese Chacko Medical PC

  • Cardiovascular Disease Physician
  • New Hyde Park, NY
National Provider Identifier
1083929053
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
VARUGHESE CHACKO MEDICAL PC
Practice address
1575 Hillside Ave
Suite 100
New Hyde Park, NY 11040-2501
Phone
(516) 417-5663
NPI assigned
Aug 13, 2010
Last updated
Aug 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Authorized official

Name
Varughese Chacko, MDNPI 1467569053
Title
Owner
Phone
(516) 417-5663

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 Physician 207RC0000X NU Primary

Addresses

Primary practice location

1575 Hillside Ave
Suite 100
New Hyde Park, NY 11040-2501

Mailing address

54 Knolls Dr N
Manhasset Hills, NY 11040-1143

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110713000063 NY Part B Supplier - Clinic/Group Practice 5991983348 Receives reassigned benefits from 1 practitioner
Practice locations: New Hyde Park, NY

National Provider Directory

National Provider Directory

Locations

970 N Broadway
Ste 308A
Yonkers, NY 10701
Phone (914) 375-2229

Practitioners & affiliated clinicians

Practitioners 2

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": "1281657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281657600000",
    "number": "1083929053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 KNOLLS DR N",
            "city": "MANHASSET HILLS",
            "state": "NY",
            "postal_code": "110401143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 HILLSIDE AVE",
            "address_2": "SUITE 100",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402501",
            "telephone_number": "516-417-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARUGHESE CHACKO MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A",
        "authorized_official_last_name": "CHACKO",
        "authorized_official_first_name": "VARUGHESE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-417-5663",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.