Individual provider Active NPI

Ferdinand Visco, M.D.

  • Cardiovascular Disease Physician
  • Elmhurst, NY
National Provider Identifier
1124010822
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
113869-1 Issued in NY
Practice address
90-02 Queens Blvd
St. John'S Queens Hospital
Elmhurst, NY 11373-4941
Phone
(718) 558-1830
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 113869-1 NY Primary

Addresses

Primary practice location

90-02 Queens Blvd
St. John'S Queens Hospital
Elmhurst, NY 11373-4941

Mailing address

70 Euclid Rd
Fort Lee, NJ 07024-6434
Phone (201) 886-8511

Other identifiers 1

IdentifierTypeStateIssuer
00208080MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070529000221 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3870690779 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
113869NYMDSocial Worker
113869-1NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Medical Practice Plan PC CurrentSince Jul 1, 2011 Accepting new patients
CMC Radiological Services PC Past Accepting new patients
St Vincents Catholic Medical Center Past Accepting new patients

Locations

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

Interoperability endpoints

  • Direct secure messaging: fvisco839738@nychhc.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124010822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 EUCLID RD",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246434",
            "telephone_number": "201-886-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90-02 QUEENS BLVD",
            "address_2": "ST. JOHN'S QUEENS HOSPITAL",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734941",
            "telephone_number": "718-558-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISCO",
        "first_name": "FERDINAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "113869-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00208080",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.