Organization Active NPI

Certified Cardiology of Roxborough PC

  • Cardiovascular Disease Physician
  • Elkins Park, PA
National Provider Identifier
1366007478
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CERTIFIED CARDIOLOGY OF ROXBOROUGH PC
Practice address
640 Anthony Rd
Elkins Park, PA 19027-1702
Phone
(215) 885-6422
NPI assigned
May 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Authorized official

Name
Andrew WoldowNPI 1467453142
Title
President
Phone
(215) 920-2338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

640 Anthony Rd
Elkins Park, PA 19027-1702

Mailing address

640 Anthony Rd
Elkins Park, PA 19027-1702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190808001735 PA Part B Supplier - Clinic/Group Practice 0446587893 Receives reassigned benefits from 1 practitioner
Practice locations: Elkins Park, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1556841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1366007478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 ANTHONY RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ANTHONY RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271702",
            "telephone_number": "215-885-6422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERTIFIED CARDIOLOGY OF ROXBOROUGH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-03",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "WOLDOW",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-920-2338"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.