Organization Active NPI

Cardiac Community Care

  • Specialist
  • Bronx, NY
National Provider Identifier
1124232202
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
195483 Issued in NY
Legal business name
CARDIAC COMMUNITY CARE
Practice address
2475 Saint Raymonds Ave
4TH Floor
Bronx, NY 10461-3124
Phone
(718) 239-5877
Fax
(718) 239-6957
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Hal N. Klestzick, D.O.
Title
Supervisor
Phone
(718) 239-5877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 195483 NY Primary

Addresses

Primary practice location

2475 Saint Raymonds Ave
4TH Floor
Bronx, NY 10461-3124

Mailing address

2475 Saint Raymonds Ave
4TH Floor
Bronx, NY 10461-3124
Phone (718) 239-5877

Other identifiers 1

IdentifierTypeStateIssuer
01971168MedicaidNY

National Provider Directory

National Provider Directory

Locations

2475 Saint Raymonds Ave
Fl 4
Bronx, NY 10461
Phone (718) 239-5877

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": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124232202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 SAINT RAYMONDS AVE",
            "address_2": "4TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613124",
            "telephone_number": "718-239-5877",
            "fax_number": "718-239-6957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 SAINT RAYMONDS AVE",
            "address_2": "4TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613124",
            "telephone_number": "718-239-5877",
            "fax_number": "718-239-6957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC COMMUNITY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLESTZICK",
        "authorized_official_first_name": "HAL",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "718-239-5877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "195483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01971168",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.