Individual provider Active NPI

Michele Nanna, MD

  • Cardiovascular Disease Physician
  • Bronx, NY
National Provider Identifier
1265538219
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
168492 Issued in NY
Practice address
1461 Astor Ave
Bronx, NY 10469-5812
Phone
(718) 655-1060
Fax
(718) 655-1012
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 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 168492 NY Primary

Addresses

Primary practice location

1461 Astor Ave
Bronx, NY 10469-5812

Mailing address

PO Box 8463
Pelham, NY 10803-8463
Phone (718) 655-1060

Other identifiers 1

IdentifierTypeStateIssuer
01008204MedicaidNY

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
I20040920001044 NY Practitioner - Cardiovascular Disease (Cardiology) 8628046448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1461 Astor Ave
Bronx, NY 10469-5812
Phone (718) 655-1060

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Care and Vascular Medicine PLLC Cardiovascular Disease CurrentSince Feb 14, 2002 Accepting new patients
Montefiore Medical Center Past Accepting new patients
Montefiore Medical Center Cardiovascular Disease Past Accepting new patients

Locations

1461 Astor Ave
Bronx, NY 10469
Phone (718) 655-1060

Networks

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

Interoperability endpoints

  • Direct secure messaging: mnanna@ccvm.bronxrhiodirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1265538219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8463",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108038463",
            "telephone_number": "718-655-1060",
            "fax_number": "718-655-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 ASTOR AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695812",
            "telephone_number": "718-655-1060",
            "fax_number": "718-655-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANNA",
        "first_name": "MICHELE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "168492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01008204",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.