South Shore Cardiovascular Medicine

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

161768-1 Issued in NY

Legal business name

SOUTH SHORE CARDIOVASCULAR MEDICINE

Practice address

137 Broadway
Suite a
Amityville, NY 11701-2742

Phone

(631) 264-2424

Fax

(631) 264-7881

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. John A Ruisi, MD

Title

President

Phone

(631) 264-2424

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dima Teitelman, MD

  • Cardiovascular Disease Physician
  • Forest Hills, NY
  • NPI 1548285497

  Cardiovascular Disease

  NPD (past)
• James Zaikowski, PHD

  • Psychologist
  • Amityville, NY
  • NPI 1235128893
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487679346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SKIPPER DR",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117955029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 BROADWAY",
            "address_2": "SUITE A",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012742",
            "telephone_number": "631-264-2424",
            "fax_number": "631-264-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE CARDIOVASCULAR MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUISI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-264-2424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "161768-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sound Body Physical Therapy
• Sound Emergency Physicians, PC
• South Bay Counseling, LCSW PC
• South Bay Psychological, P.C.
• South Oaks Hospital
• South Shore Cardiovascular Medicine P C
• South Shore Collaborative Psychiatry NP PLLC
• South Shore Magnetic Resonance Imaging Associates PC
• South Shore Optometric Associates, PC
• South Shore Therapeutic Massage, P.C.

• All providers in Amityville, NY
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.