Individual provider Active NPI

Hachiro Nakamura, M.D.

  • Cardiovascular Disease Physician
  • Huntington, NY
National Provider Identifier
1306850235
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
112130-1 Issued in NY
Practice address
325 Park Ave
Huntington, NY 11743-2779
Phone
(631) 351-3777
Fax
(631) 351-1890
NPI assigned
Jul 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Cardiovascular Disease Physician 207RC0000X 112130-1 NY Primary

Addresses

Primary practice location

325 Park Ave
Huntington, NY 11743-2779

Mailing address

325 Park Ave
Huntington, NY 11743-2779
Phone (631) 351-3777

Other identifiers 1

IdentifierTypeStateIssuer
00380305MedicaidNY

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
I20110120000160 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3577742774 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112130NYMDClinical Social Worker
112130-1NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Cardiovascular Disease CurrentSince Jan 1, 2017 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Cardiovascular Disease CurrentSince Jun 15, 1999 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Cardiovascular Disease CurrentSince Jun 15, 1999 Accepting new patients

Locations

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

300 Community Dr
Manhasset, NY 11030

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306850235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432779",
            "telephone_number": "631-351-3777",
            "fax_number": "631-351-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432779",
            "telephone_number": "631-351-3777",
            "fax_number": "631-351-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "HACHIRO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "112130-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00380305",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.