NPIMap

Individual provider Active NPI

Nishant Koradia, M.D.

  • Interventional Cardiology Physician
  • Erie, PA
National Provider Identifier
1407039530
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD434947 Issued in PA
Practice address
2315 Myrtle St Ste 190
Erie, PA 16502-4604
Phone
(814) 453-7767
Fax
(814) 454-6667
NPI assigned
Dec 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD434947 PA
Interventional Cardiology Physician 207RI0011X MD434947 PA Primary
Internal Medicine Physician 207R00000X MD434947 PA

Addresses

Primary practice location

2315 Myrtle St Ste 190
Erie, PA 16502-4604

Mailing address

2315 Myrtle St Ste 190
Erie, PA 16502-4604
Phone (814) 453-7767

Other identifiers 2

IdentifierTypeStateIssuer
02987575MedicaidNY
1022074610001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nkoradia148987@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080723000103 PA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 0941373021 Reassigns benefits to 1 organization
I20190523001728 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 0941373021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chautauqua Medical Practice PCGroup PAC ID 5294920203, 103 clinicians
Saint Vincent Consultants in Cardiovascular DiseasesGroup PAC ID 7214124221, 27 clinicians

Practice addresses (Care Compare)

189 E Main St
Westfield, NY 14787-1104
Phone (716) 793-2221

2315 Myrtle St
Suite 190
Erie, PA 16502-4604
Phone (814) 453-7767

4936 Main St
Bemus Point, NY 14712-9667
Phone (716) 386-2414

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting31
Pacemaker insertion or repair1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Chautauqua Medical Practice, P.C. CurrentSince Jul 20, 2020 Accepting new patients
Saint Vincent Consultants in Cardiovascular Diseases Cardiovascular Disease CurrentSince Nov 1, 2010 Accepting new patients
Saint Vincent Health Center Past Accepting new patients
Erie Physicians Network PC PastSince Apr 30, 2003 Accepting new patients
Laser Eye Surgery of Erie, Inc PastSince Oct 21, 1998 Accepting new patients

Locations

189 E Main St
Westfield, NY 14787
Phone (716) 326-4921

300 York St
Corry, PA 16407
Phone (814) 664-3979

153 E 13th St
Ste 1300
Erie, PA 16503
Phone (814) 452-5081

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

2315 Myrtle St
Ste 190
Erie, PA 16502
Phone (814) 453-7767

232 W 25th St
#3R
Erie, PA 16544
Phone (814) 452-5530

Interoperability endpoints

  • Direct secure messaging: nkoradia148987@direct.ahn.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1407039530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE 190",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024604",
            "telephone_number": "814-453-7767",
            "fax_number": "814-454-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE 190",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024604",
            "telephone_number": "814-453-7767",
            "fax_number": "814-454-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORADIA",
        "first_name": "NISHANT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD434947",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD434947",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD434947",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02987575",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022074610001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkoradia148987@direct.ahn.org",
            "affiliation": "N",
            "address_1": "2315 Myrtle St Ste 190",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165024604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.