Individual provider Active NPI

Avni Thakore, M.D.

  • Cardiovascular Disease Physician
  • Greenvale, NY
National Provider Identifier
1144492091
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
248021 Issued in NY
Practice address
2200 Northern Blvd Ste 116
Greenvale, NY 11548-1220
Phone
(516) 563-7930
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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 248021 NY Primary

Addresses

Primary practice location

2200 Northern Blvd Ste 116
Greenvale, NY 11548-1220

Mailing address

55 Water St
12TH Floor, Credentialing
New York, NY 10041-0004
Phone (646) 680-2888

Other practice location 1

1991 Marcus Ave
New Hyde Park, NY 11042-2057
Phone (516) 354-1600 ext. 4737

Other identifiers 1

IdentifierTypeStateIssuer
03240580MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C Cardiovascular Disease CurrentSince Dec 12, 2017 Accepting new patients
CHS Physician Partners, PC CurrentSince Dec 12, 2017 Accepting new patients
Conciergemd, P.C. Cardiovascular Disease Current Accepting new patients
CHS Physician Partners, PC Current Accepting new patients

Locations

2200 Northern Blvd
Ste 112
Greenvale, NY 11548
Phone (516) 484-6777

2200 Northern Blvd
Ste 116
Greenvale, NY 11548
Phone (516) 365-2144

1991 Marcus Ave
North New Hyde Park, NY 11042
Phone (516) 200-0025

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Interoperability endpoints

  • Direct secure messaging: athakore97972@direct-chsli.net

Organizations & group practices 4

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1144492091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST",
            "address_2": "12TH FLOOR, CREDENTIALING",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NORTHERN BLVD STE 116",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481220",
            "telephone_number": "516-563-7930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1991 Marcus Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110422057",
            "country_code": "US",
            "telephone_number": "516-354-1600 x4737",
            "fax_number": "516-941-4677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAKORE",
        "first_name": "AVNI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "248021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03240580",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenvale, NY

Sources for this page

Verify at the official NPI Registry.