Active NPI
Tri-City Cardiology Care, PLLC
- Cardiovascular Disease Physician
- Troy, NY
National Provider Identifier
1104258342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- TRI-CITY CARDIOLOGY CARE, PLLC
- Practice address
- 258 Hoosick St
Suite 107
Troy, NY 12180-2444 - Phone
- (518) 322-5295
- NPI assigned
- Jul 30, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Hussain Khawajah, MD
- Title
- Owner
- Phone
- (518) 322-5295
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
258 Hoosick St
Suite 107
Troy, NY 12180-2444
Mailing address
258 Hoosick St
Suite 107
Troy, NY 12180-2444
Phone (518) 322-5295
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
258 Hoosick St
Ste 107
Troy, NY 12180
Phone (518) 322-5295
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Troy, NY
- NPI 1154422236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1375747200000",
"number": "1104258342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 HOOSICK ST",
"address_2": "SUITE 107",
"city": "TROY",
"state": "NY",
"postal_code": "121802444",
"telephone_number": "518-322-5295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 HOOSICK ST",
"address_2": "SUITE 107",
"city": "TROY",
"state": "NY",
"postal_code": "121802444",
"telephone_number": "518-322-5295"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRI-CITY CARDIOLOGY CARE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-07-30",
"last_updated": "2013-08-06",
"status": "A",
"authorized_official_last_name": "KHAWAJAH",
"authorized_official_first_name": "HUSSAIN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "518-322-5295",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Troy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.