Organization Active NPI

Vital Health Medical Associates PLLC

  • Cardiovascular Disease Physician
  • Jackson Heights, NY
National Provider Identifier
1548651003
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
VITAL HEALTH MEDICAL ASSOCIATES PLLC
Practice address
3730 73Rd St Ste PQ
Jackson Heights, NY 11372-6233
Phone
(718) 247-7340
NPI assigned
Feb 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
Towhid Hossain ShibleeNPI 1033437827
Title
M.D
Phone
(718) 247-7340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

3730 73Rd St Ste PQ
Jackson Heights, NY 11372-6233

Mailing address

3730 73Rd St Ste PQ
Jackson Heights, NY 11372-6233
Phone (718) 247-7340

Other practice location 1

3751A 90th St
Jackson Heights, NY 11372-7829
Phone (516) 457-4539

Other practice location 2

3720 76th St
Jackson Heights, NY 11372-6549
Phone (718) 247-7340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200909001554 NY Part B Supplier - Clinic/Group Practice 2769800663 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson Heights, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1548651003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 73RD ST STE PQ",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726233",
            "telephone_number": "718-247-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 73RD ST STE PQ",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113726233",
            "telephone_number": "718-247-7340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3751A 90th St",
            "address_purpose": "LOCATION",
            "city": "Jackson Heights",
            "state": "NY",
            "postal_code": "113727829",
            "country_code": "US",
            "telephone_number": "516-457-4539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3720 76th St",
            "address_purpose": "LOCATION",
            "city": "Jackson Heights",
            "state": "NY",
            "postal_code": "113726549",
            "country_code": "US",
            "telephone_number": "718-247-7340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VITAL HEALTH MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-05",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "SHIBLEE",
        "authorized_official_first_name": "TOWHID",
        "authorized_official_middle_name": "HOSSAIN",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "718-247-7340"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.