Organization Active NPI

Southbay Cardiovascular Assoc PC

  • Cardiovascular Disease Physician
  • West Islip, NY
National Provider Identifier
1336110089
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SOUTHBAY CARDIOVASCULAR ASSOC PC
Practice address
540 Union Blvd
West Islip, NY 11795-3105
Phone
(631) 669-2555
Fax
(631) 669-5787
NPI assigned
Jan 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Michael Aaron, MD
Title
President
Phone
(631) 669-2555

Specialties & licenses 1

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

Addresses

Primary practice location

540 Union Blvd
West Islip, NY 11795-3105

Mailing address

540 Union Blvd
West Islip, NY 11795-3105
Phone (631) 669-2555

Other identifiers 1

IdentifierTypeStateIssuer
01631447MedicaidNY

National Provider Directory

National Provider Directory

Locations

540 Union Blvd
West Islip, NY 11795
Phone (631) 669-2555

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": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1336110089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 UNION BLVD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953105",
            "telephone_number": "631-669-2555",
            "fax_number": "631-669-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 UNION BLVD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953105",
            "telephone_number": "631-669-2555",
            "fax_number": "631-669-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHBAY CARDIOVASCULAR ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "AARON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-669-2555",
        "authorized_official_credential": "MD"
    },
    "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": "01631447",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.