Organization Active NPI

North Medical Cardiovascular Group PC

  • Cardiovascular Disease Physician
  • Fayetteville, NY
National Provider Identifier
1184676355
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
NORTH MEDICAL CARDIOVASCULAR GROUP PC
Practice address
4507 Medical Center Dr
Fayetteville, NY 13066-6604
Phone
(315) 663-0500
Fax
(315) 663-0514
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Authorized official

Name
Mrs. Elizabeth Sassano
Title
Coo
Phone
(315) 752-0141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

4507 Medical Center Dr
Fayetteville, NY 13066-6604

Mailing address

6221 State Route 31
Suite 104
Cicero, NY 13039-8715
Phone (315) 752-0141

Other identifiers 1

IdentifierTypeStateIssuer
02130289MedicaidNY

Other names 1

  • Cardiovascular Group of Syracuse Doing business as

National Provider Directory

National Provider Directory

Locations

6221 State Route 31
Ste 10
Cicero, NY 13039

5100 W Taft Rd
Ste 4J
Liverpool, NY 13088
Phone (315) 701-2170

5100 W Taft Rd
#5J
Liverpool, NY 13088
Phone (315) 452-2014

Practitioners & affiliated clinicians

Practitioners 1

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": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1184676355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 STATE ROUTE 31",
            "address_2": "SUITE 104",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130398715",
            "telephone_number": "315-752-0141",
            "fax_number": "315-752-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4507 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666604",
            "telephone_number": "315-663-0500",
            "fax_number": "315-663-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MEDICAL CARDIOVASCULAR GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "SASSANO",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "315-752-0141",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02130289",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiovascular Group of Syracuse",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.