Cardiovascular Specialists, LLC
Organization Active NPI Cardiovascular Disease Physician · Logan, OH
NPI 1336375757 · NPPES record last updated Jul 9, 2012
Key facts
- NPI
- 1336375757
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 35082038 (OH)
- Legal business name
- CARDIOVASCULAR SPECIALISTS, LLC
- Practice address
- 601 State Route 664 N
Logan, OH 43138-8541 - Phone
- (740) 653-7511
- Fax
- (740) 653-7512
- NPI assigned
- Jun 1, 2009
- Organization subpart
- No
Authorized official
- Name
- Shantanu Sinha, M.D.
- Title
- Co-Owner
- Phone
- (740) 653-7511
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 1
Practitioners 3
-
Kaitlyn Noel Cummin, CNP
-
Mobusher Mahmud, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090729000064 | OH | Part B Supplier - Clinic/Group Practice | 3678626314 |
Receives reassigned benefits from 11 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Canal Winchester, OH; Lancaster, OH; Logan, OH |
National Provider Directory
- Tax ID family
- Cardiovascular Specialists LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | 35082038 | OH | Yes |
| Interventional Cardiology Physician |
207RI0011X | 35082038 | OH | |
| Nuclear Cardiology Physician |
207UN0901X | 35082038 | OH |
Addresses
Primary practice location
601 State Route 664 N
Logan, OH 43138-8541
Mailing address
618 Pleasantville Rd
Suite 101
Lancaster, OH 43130-3312
Phone (740) 653-7511
Other providers in Logan, OH
- Rachel Dawn Cairns
- Emily Campbell
- Alyssa Canavan
- Capitol City Cardiology, Inc.
- Cardiopulmonary Care Inc
- Carlin House Assisted Living
- Danielle Carlton
- Jamie Carnell
- Douglas B Carr
- Kirsten Carr
All providers in Logan, OH · Cardiovascular Disease Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.