NPIMap

Organization Active NPI

Ansaarie Cardiac & Endovascular Center of Excellence

  • Cardiovascular Disease Physician
  • East Palatka, FL
National Provider Identifier
1346791498
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME121178 Issued in FL
Legal business name
ANSAARIE CARDIAC & ENDOVASCULAR CENTER OF EXCELLENCE
Doing business as
Ansaarie Cardiac & Endovascular Center of Excellence
Practice address
215 Hwy 17S
East Palatka, FL 32131-4087
Phone
(386) 232-9203
Fax
(386) 222-3064
NPI assigned
Oct 24, 2016
Last updated
Jun 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Authorized official

Name
Imran Ansaarie, M.D
Title
Owner
Phone
(386) 232-9203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME121178 FL Primary

Addresses

Primary practice location

215 Hwy 17S
East Palatka, FL 32131-4087

Mailing address

209 Pinehurst Pointe Dr
St Augustine, FL 32092-3703
Phone (386) 232-9203

Other practice location 1

1301 Plantation Island Dr S Ste 401A
Saint Augustine, FL 32080-3118
Phone (386) 232-9203

Other identifiers 1

IdentifierTypeStateIssuer
012828200MedicaidFL

Other names 1

  • ANSAARIE CARDIAC & ENDOVASCULAR CENTER OF EXCELLENCE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170106000060 FL Part B Supplier - Clinic/Group Practice 8123309127 Receives reassigned benefits from 7 practitioners
Practice locations: East Palatka, FL; Saint Augustine, FL

National Provider Directory

National Provider Directory
Tax ID family
Ansaarie Cardiac Endovascular Center of Excellence2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1301 Plantation Island Dr S
Ste 401A
Saint Augustine, FL 32080
Phone (386) 232-9203

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CGGIAD

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1346791498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PINEHURST POINTE DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923703",
            "telephone_number": "386-232-9203",
            "fax_number": "386-222-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HWY 17S",
            "city": "EAST PALATKA",
            "state": "FL",
            "postal_code": "321314087",
            "telephone_number": "386-232-9203",
            "fax_number": "386-222-3064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Plantation Island Dr S Ste 401A",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320803118",
            "country_code": "US",
            "telephone_number": "386-232-9203",
            "fax_number": "386-222-3064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANSAARIE CARDIAC & ENDOVASCULAR CENTER OF EXCELLENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "ANSAARIE",
        "authorized_official_first_name": "IMRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-232-9203",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME121178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012828200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANSAARIE CARDIAC & ENDOVASCULAR CENTER OF EXCELLENCE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ANSAARIE CARDIAC & ENDOVASCULAR CENTER OF EXCELLENCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.