NPIMap

Organization Active NPI

Capital Cardiology Associates P a

  • Cardiovascular Disease Physician
  • Trenton, NJ
National Provider Identifier
1548204142
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CAPITAL CARDIOLOGY ASSOCIATES P A
Practice address
40 Fuld St
Suite 400
Trenton, NJ 08638
Phone
(609) 396-1644
Fax
(609) 394-9526
NPI assigned
Jun 15, 2006
Last updated
Oct 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Prabodh Damani, MDNPI 1811931488
Title
Doctor
Phone
(609) 396-1644

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

40 Fuld St
Suite 400
Trenton, NJ 08638

Mailing address

40 Fuld St
Suite 400
Trenton, NJ 08638
Phone (609) 396-1644

Other identifiers 1

IdentifierTypeStateIssuer
2859106MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070428000084 NJ Part B Supplier - Clinic/Group Practice 1951394162 Receives reassigned benefits from 6 practitioners
Practice locations: Hamilton, NJ; Trenton, NJ

National Provider Directory

National Provider Directory

Locations

3379 Quakerbridge Rd
Ste 111
Hamilton, NJ 08619
Phone (609) 249-9000

Practitioners & affiliated clinicians

Practitioners 9

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": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1548204142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 FULD ST",
            "address_2": "SUITE 400",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08638",
            "telephone_number": "609-396-1644",
            "fax_number": "609-394-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 FULD ST",
            "address_2": "SUITE 400",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08638",
            "telephone_number": "609-396-1644",
            "fax_number": "609-394-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL CARDIOLOGY ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "DAMANI",
        "authorized_official_first_name": "PRABODH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "609-396-1644",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2859106",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.