Advanced Cardiovascular Center LLC
Organization Active NPI Interventional Cardiology Physician · Goodyear, AZ
NPI 1346925872 · NPPES record last updated Jul 7, 2026
Key facts
- NPI
- 1346925872
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Interventional Cardiology Physician 207RI0011X
- Legal business name
- ADVANCED CARDIOVASCULAR CENTER LLC
- Practice address
- 13481 W McDowell Rd Ste 400
Goodyear, AZ 85395-2725 - Phone
- (217) 720-6093
- NPI assigned
- Jun 21, 2023
- Organization subpart
- No
Authorized official
- Name
- Ish Kumar Singla
- Title
- Ceo
- Phone
- (217) 720-6093
Practitioners 7
-
Ish Kumar Singla, MD
-
Basil Al Khatib, M.D.
-
Sara Komosa, FNP-C
-
Sara Serbus, FNP-C
-
John Adan, MD
-
Nitin Garg, MBBS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230918002701 | AZ | Part B Supplier - Clinic/Group Practice | 6406210822 |
Receives reassigned benefits from 6 practitioners Practice locations: Buckeye, AZ; Surprise, AZ; Sun City, AZ; Goodyear, AZ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician |
207RI0011X | Yes | ||
| Vascular Surgery Physician |
2086S0129X |
Addresses
Primary practice location
13481 W McDowell Rd Ste 400
Goodyear, AZ 85395-2725
Mailing address
13481 W McDowell Rd Ste 400
Goodyear, AZ 85395-2725
Phone (217) 720-6093
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All providers in Goodyear, AZ · Interventional Cardiology Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2026. 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.