Organization Active NPI

New York Heart and Vascular Specialists PC

  • Cardiovascular Disease Physician
  • Brooklyn, NY
National Provider Identifier
1649585399
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
244121 Issued in NY
Legal business name
NEW YORK HEART AND VASCULAR SPECIALISTS PC
Practice address
3309 Church Ave
Brooklyn, NY 11203-2711
Phone
(347) 350-9344
Fax
(718) 693-4176
NPI assigned
Aug 18, 2010
Last updated
Aug 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Authorized official

Name
Dr. Gopi Krishna Punukollu, M.D.NPI 1184839284
Title
Doctor
Phone
(347) 350-9344

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 Physician 207RC0000X 244121 NY Primary

Addresses

Primary practice location

3309 Church Ave
Brooklyn, NY 11203-2711

Mailing address

3309 Church Ave
Brooklyn, NY 11203-2711
Phone (347) 350-9344

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120202000598 NY Part B Supplier - Clinic/Group Practice 1557528569 Receives reassigned benefits from 8 practitioners
Practice locations: Brooklyn, NY; Middle Village, NY; South Richmond Hill, NY; Westbury, NY; Woodhaven, NY

National Provider Directory

National Provider Directory
Tax ID family
New York Heart and Vascular Specialists PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1471 DeKalb Ave
Fl 4
Brooklyn, NY 11237
Phone (347) 425-1789

1600 Stewart Ave
Ste 1150
Westbury, NY 11590
Phone (516) 833-5505

Practitioners & affiliated clinicians

Practitioners 11

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": "1282089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1649585399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032711",
            "telephone_number": "347-350-9344",
            "fax_number": "718-693-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032711",
            "telephone_number": "347-350-9344",
            "fax_number": "718-693-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK HEART AND VASCULAR SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "PUNUKOLLU",
        "authorized_official_first_name": "GOPI",
        "authorized_official_middle_name": "KRISHNA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "347-350-9344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "244121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.