Indian River Cardiology PA

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

ME0050599 Issued in FL

Legal business name

INDIAN RIVER CARDIOLOGY PA

Practice address

3607 15TH Ave Ste a
Vero Beach, FL 32960-6513

Phone

(772) 562-8522

Fax

(772) 562-0317

NPI assigned

Jun 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles N Celano, M.D.NPI 1174573794

Title

Owner

Phone

(772) 562-8522

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JGBECD

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles N Celano, MD

  • Cardiovascular Disease Physician
  • Vero Beach, FL
  • NPI 1174573794
  Medicare reassignment Care Compare group NPD Authorized official
• Brenda Corripio, ARNP

  • Adult Health Nurse Practitioner
  • Vero Beach, FL
  • NPI 1205988730
  Medicare reassignment Care Compare group
• Anne Stubbs Cooney, LCSW

  • Clinical Social Worker
  • Vero Beach, FL
  • NPI 1487762910
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1124069091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 15TH AVE STE A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606513",
            "telephone_number": "772-562-8522",
            "fax_number": "772-562-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 15TH AVE STE A",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606513",
            "telephone_number": "772-562-8522",
            "fax_number": "772-562-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER CARDIOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "CELANO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-562-8522",
        "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": "FL",
            "license": "ME0050599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062571000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lubka B. Ilieva, D.O.
• Latia Holder Ilyadis, D.O.
• Imagine Schools at South Vero
• Indian River Assisting Services PA
• Indian River Cardiac Rehab Inc
• Indian River Coordinators
• Indian River Coordinators, Inc.
• Indian River County Healthy Start Coalition, Inc
• Indian River County School District
• Indian River County School District

• Cardiovascular Disease Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.