Organization Active NPI

Heart Health of the South Shore PC

  • Cardiovascular Disease Physician
  • Woodmere, NY
National Provider Identifier
1104262088
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
236218 Issued in NY
Legal business name
HEART HEALTH OF THE SOUTH SHORE PC
Practice address
949 Central Ave
Suite 207
Woodmere, NY 11598-1204
Phone
(516) 218-2510
Fax
(516) 341-7077
NPI assigned
May 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Authorized official

Name
Dr. David J Hersh, M.D.NPI 1588854921
Title
President
Phone
(516) 218-2510

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: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 236218 NY Primary

Addresses

Primary practice location

949 Central Ave
Suite 207
Woodmere, NY 11598-1204

Mailing address

949 Central Ave
Suite 207
Woodmere, NY 11598-1204
Phone (516) 218-2510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130815000202 NY Part B Supplier - Clinic/Group Practice 4688816903 Receives reassigned benefits from 1 practitioner
Practice locations: Merrick, NY; South Ozone Park, NY; Woodmere, NY

National Provider Directory

National Provider Directory

Locations

949 Central Ave
Ste 207
Woodmere, NY 11598
Phone (516) 218-2510

Practitioners & affiliated clinicians

Practitioners 2

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": "1368748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1104262088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 CENTRAL AVE",
            "address_2": "SUITE 207",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981204",
            "telephone_number": "516-218-2510",
            "fax_number": "516-341-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 CENTRAL AVE",
            "address_2": "SUITE 207",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981204",
            "telephone_number": "516-218-2510",
            "fax_number": "516-341-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART HEALTH OF THE SOUTH SHORE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-17",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "HERSH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-218-2510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "236218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodmere, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.

Verify at the official NPI Registry.