Individual provider Active NPI

Luis Mario Astudillo, MD

  • Cardiovascular Disease Physician
  • Bronx, NY
National Provider Identifier
1114974623
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
243249 Issued in NY
Practice address
3131 Grand Concourse
Suite 1B
Bronx, NY 10468-1442
Phone
(718) 295-7900
Fax
(718) 295-4160
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 243249 NY Primary

Addresses

Primary practice location

3131 Grand Concourse
Suite 1B
Bronx, NY 10468-1442

Mailing address

PO Box 837
Hartsdale, NY 10530-0837
Phone (718) 562-6570

Other identifiers 1

IdentifierTypeStateIssuer
350518195AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140218001884 NJ Practitioner - Cardiovascular Disease (Cardiology) 7719877893 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians
Palisades Cardiology Services PAGroup PAC ID 0547256836, 6 clinicians

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5045

7600 River Rd
North Bergen, NJ 07047-6217
Phone 2017701103110

Hospital & facility affiliations

  • Palisades Medical Center Hospital, North Bergen, NJ, CCN 310003
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2022 Accepting new patients
Humc Cardiovascular Partners, PC Cardiovascular Disease CurrentSince Sep 23, 2013 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2022 Accepting new patients
Cardiology Unlimited PC Cardiovascular Disease Past Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients
North Shore-Lij Medical PC Cardiovascular Disease Past Accepting new patients

Locations

103 River Rd
Edgewater, NJ 07020
Phone (201) 941-8100

200 Grand Ave
Ste 202
Englewood, NJ 07631
Phone (201) 541-1220

301 Bridge Plz N
Ste 3
Fort Lee, NJ 07024
Phone (848) 308-4690

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

7600 River Rd
North Bergen, NJ 07047
Phone (201) 854-5000

7650 River Rd
Ste 300
North Bergen, NJ 07047
Phone (201) 224-8831

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDIHAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
  • Direct secure messaging: luis.astudillo@direct.hackensackmeridian.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1114974623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 837",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105300837",
            "telephone_number": "718-562-6570",
            "fax_number": "718-346-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 GRAND CONCOURSE",
            "address_2": "SUITE 1B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104681442",
            "telephone_number": "718-295-7900",
            "fax_number": "718-295-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASTUDILLO",
        "first_name": "LUIS",
        "middle_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "243249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350518195A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.