Individual provider Active NPI

Robert N Vincent, M.D.

  • Pediatric Cardiology Physician
  • Atlanta, GA
National Provider Identifier
1225063308
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
029813 Issued in GA
Practice address
5455 Meridian Mark Rd
Ste 530
Atlanta, GA 30342
Phone
(404) 256-2593
Fax
(678) 547-1494
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 029813 GA Primary

Addresses

Primary practice location

5455 Meridian Mark Rd
Ste 530
Atlanta, GA 30342

Mailing address

2835 Brandywine Rd
#300
Atlanta, GA 30341
Phone (404) 256-2593

Other identifiers 1

IdentifierTypeStateIssuer
00349951BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200428000822 NY Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 4183890916 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029813GAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Apr 6, 2020 Accepting new patients
Boston Children'S Health Physicians, LLP Pediatric Cardiology CurrentSince Apr 6, 2020 Accepting new patients

Locations

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

19 Bradhurst Ave
Ste 1400
Hawthorne, NY 10532
Phone (914) 493-7997

40 Sunshine Cottage Rd
Ofc 1ND
Valhalla, NY 10595

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: robert.vincent.p1@direct.cwpw.nextgenshare.com

Organizations & group practices 2

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225063308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 BRANDYWINE RD",
            "address_2": "#300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30341",
            "telephone_number": "404-256-2593",
            "fax_number": "678-547-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 MERIDIAN MARK RD",
            "address_2": "STE 530",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-256-2593",
            "fax_number": "678-547-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "ROBERT",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "029813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00349951B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.