NPIMap

Organization Active NPI

Cardiac Rehab Center LLC

  • Cardiac Rehabilitation Clinic/Center
  • Nanticoke, PA
National Provider Identifier
1457990749
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiac Rehabilitation Clinic/CenterTaxonomy code 261QR0404X
Legal business name
CARDIAC REHAB CENTER LLC
Practice address
128 W Washington St
Nanticoke, PA 18634-3113
Phone
(718) 534-7888
Fax
(718) 874-0088
NPI assigned
Jan 3, 2020
Last updated
Jan 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Authorized official

Name
Dr. Shahid Rasul, MD
Title
President
Phone
(917) 774-1787

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Clinic/Center 261Q00000X NU
Physical Therapy Clinic/Center 261QP2000X NU
Primary Care Clinic/Center 261QP2300X NU
Cardiac Rehabilitation Clinic/Center 261QR0404X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

128 W Washington St
Nanticoke, PA 18634-3113

Mailing address

PO Box 3945
New Hyde Park, NY 11040-8945
Phone (917) 774-1787

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1457990749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3945",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110408945",
            "telephone_number": "917-774-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W WASHINGTON ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186343113",
            "telephone_number": "718-534-7888",
            "fax_number": "718-874-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "RASUL",
        "authorized_official_first_name": "SHAHID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-774-1787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0404X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Cardiac Facilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanticoke, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.