NPIMap

Organization Active NPI

Amarnath Avancha PA

  • Cardiovascular Disease Physician
  • Passaic, NJ
National Provider Identifier
1427064203
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MA058773 Issued in NJ
Legal business name
AMARNATH AVANCHA PA
Practice address
124 Gregory Ave.
Unit 102
Passaic, NJ 07055-4856
Phone
(973) 777-1132
Fax
(973) 458-9850
NPI assigned
Jul 31, 2006
Last updated
Oct 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
Dr. Amarnath Avancha, MD,FACCNPI 1740457571
Title
President
Phone
(973) 777-1132

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MA058773 NJ Primary
Nuclear Cardiology Physician 207UN0901X MA058773 NJ

Addresses

Primary practice location

124 Gregory Ave.
Unit 102
Passaic, NJ 07055-4856

Mailing address

124 Gregory Ave
Unit 102
Passaic, NJ 07055-4856
Phone (973) 777-1132

Other identifiers 1

IdentifierTypeStateIssuer
7462409MedicaidNJ

National Provider Directory

National Provider Directory

Locations

124 Gregory Ave
Ste 102
Passaic, NJ 07055
Phone (973) 777-1132

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": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1427064203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 GREGORY AVE",
            "address_2": "UNIT 102",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554856",
            "telephone_number": "973-777-1132",
            "fax_number": "973-458-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 GREGORY AVE.",
            "address_2": "UNIT 102",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554856",
            "telephone_number": "973-777-1132",
            "fax_number": "973-458-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARNATH AVANCHA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "AVANCHA",
        "authorized_official_first_name": "AMARNATH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-777-1132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD,FACC"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "MA058773",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NJ",
            "license": "MA058773",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7462409",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.