NPIMap

Individual provider Active NPI

Theofanis Tsiamtsiouris, MD

  • Interventional Cardiology Physician
  • Roslyn, NY
National Provider Identifier
1306897541
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
1984011 Issued in NY
Practice address
100 Port Washington Blvd Ste 105
Roslyn, NY 11576
Phone
(516) 390-9640
Fax
(516) 390-9650
NPI assigned
May 12, 2006
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 1984011 NY
Interventional Cardiology Physician 207RI0011X 1984011 NY Primary

Addresses

Primary practice location

100 Port Washington Blvd Ste 105
Roslyn, NY 11576

Mailing address

100 Port Washington Blvd Ste 105
Roslyn, NY 11576
Phone (516) 390-9640

Other identifiers 1

IdentifierTypeStateIssuer
02174312MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040729001339 NY Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0345210993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
State University of New York at Stony Brook, School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347

1000 N Village Ave
Rockville Center, NY 11570-1000

16303 Horace Harding Expy
Suite 100
Fresh Meadows, NY 11365-1449
Phone (718) 454-4600

2200 Northern Blvd
Greenvale, NY 11548-1220

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1984011NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C Cardiovascular Disease CurrentSince Sep 1, 2008 Accepting new patients
CHS Physician Partners, PC Interventional Cardiology Current Accepting new patients
St Francis Hospital Past Accepting new patients
Bethpage Medical, PLLC Past Accepting new patients
Mantia Medical Associates Past Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients
Nrad Medical Associates, PC Past Accepting new patients
Meadows Nuclear Spect Imaging, PC Past Accepting new patients

Locations

16303 Horace Harding Expy
Fresh Meadows, NY 11365
Phone (718) 353-1155

16303 Horace Harding Expy
Ste 100
Fresh Meadows, NY 11365
Phone (718) 454-4600

2200 Northern Blvd
Ste 102
Greenvale, NY 11548

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

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

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

100 Port Washington Blvd
Ste 105
Roslyn, NY 11576
Phone (516) 390-9640

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: ttsiamtsiouris13800@direct-chsli.net

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1306897541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD STE 105",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-390-9640",
            "fax_number": "516-390-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD STE 105",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "11576",
            "telephone_number": "516-390-9640",
            "fax_number": "516-390-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIAMTSIOURIS",
        "first_name": "THEOFANIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "1984011",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "1984011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02174312",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

Verify at the official NPI Registry.