Atlantic Cardiovascular Care PC

Organization Active NPI Cardiovascular Disease Physician · Mount Vernon, NY

NPI 1508401217 · NPPES record last updated Sep 11, 2023

Key facts

NPI
1508401217
Entity type
Organization (NPI type 2)
Primary specialty
Cardiovascular Disease Physician 207RC0000X
Legal business name
ATLANTIC CARDIOVASCULAR CARE PC
Practice address
504 Gramatan Ave
Mount Vernon, NY 10552-3009
Phone
(732) 426-7948
NPI assigned
Nov 18, 2019
Organization subpart
No

Authorized official

Name
Maday C Gonzalez, MD
Title
Cardiologist
Phone
(646) 415-4122

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20221222001106 NY Part B Supplier - Clinic/Group Practice 5092185686 Receives reassigned benefits from 2 practitioners
Practice locations: White Plains, NY; Mount Vernon, NY

National Provider Directory

Tax ID family
Atlantic Cardiovascular Care (2 organizations share this tax ID)

Locations

105 Stevens Ave
Ste 501
Mount Vernon, NY 10550
Phone (329) 215-1388

504 Gramatan Ave
Mount Vernon, NY 10552
Phone (914) 664-7323

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCCADD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RC0000X Yes

Addresses

Primary practice location

504 Gramatan Ave
Mount Vernon, NY 10552-3009

Mailing address

504 Gramatan Ave
Mount Vernon, NY 10552-3009
Phone (732) 426-7948

Other identifiers

IdentifierTypeStateIssuer
112688592OtherNYDRIVER LICENSE

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://www.montefiore.org Direct

Other providers in Mount Vernon, NY

All providers in Mount Vernon, NY · Cardiovascular Disease Physician in New York

Sources for this page

Verify at the official NPI Registry.