Avantgarde Cardiovascular Services PC

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

AVANTGARDE CARDIOVASCULAR SERVICES PC

Practice address

11124 W California Ave
Suite G
Youngtown, AZ 85363-1246

Phone

(623) 583-2073

NPI assigned

Jan 31, 2023

Last updated

Jan 31, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

AVANTGARDE CARDIOVASCULAR SERVICES PCAs reported in NPPES

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

Authorized official

Name

Peggy Jeter

Title

Office Manager

Phone

(623) 583-2073

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Part of

Avantgarde Cardiovascular Services PC

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Kwesi Amponsah, MD

  • Interventional Cardiology Physician
  • Peoria, AZ
  • NPI 1518233899
  Medicare reassignment NPD

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1134835358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11124 W CALIFORNIA AVE",
            "address_2": "SUITE G",
            "city": "YOUNGTOWN",
            "state": "AZ",
            "postal_code": "853631246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11124 W CALIFORNIA AVE",
            "address_2": "SUITE G",
            "city": "YOUNGTOWN",
            "state": "AZ",
            "postal_code": "853631246",
            "telephone_number": "623-583-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTGARDE CARDIOVASCULAR SERVICES PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVANTGARDE CARDIOVASCULAR SERVICES PC",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "JETER",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "623-583-2073"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Lyn Ashlock, COTA/L
• Aspire Health, LLC
• Atlantis Anesthesia Associates Az PLLC
• Atlantis Global Research Institute, PLLC.
• Atlantis Medical Specialist Az, PLLC
• Ayodeji Ayoola
• Adriana Del Carmen Bedoya
• R Barnabas Bickerton, DC
• Sao Brima
• Karen L Brozik, MA, LPC

• Interventional Cardiology Physician in Youngtown, AZ
• Providers in Youngtown, AZ by specialty
• Interventional Cardiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.