Individual provider Active NPI

Anthony J Kyreakakis, MD

  • Cardiovascular Disease Physician
  • Hoboken, NJ
National Provider Identifier
1659382349
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MA39279 Issued in NJ
Practice address
604 Willow Ave
Hoboken, NJ 07030-4175
Phone
(201) 659-3311
Fax
(201) 795-0924
NPI assigned
Aug 10, 2006
Last updated
Aug 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MA39279 NJ Primary

Addresses

Primary practice location

604 Willow Ave
Hoboken, NJ 07030-4175

Mailing address

604 Willow Avenue
Hoboken, NJ 07030
Phone (201) 659-3311

Other identifiers 1

IdentifierTypeStateIssuer
1387405MedicaidNJ

Other names 1

  • Anthony Kyreakakis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050914000172 NJ Practitioner - Cardiovascular Disease (Cardiology) 3779516406 Reassigns benefits to 1 organization
Practice locations: Hoboken, NJ

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

604 Willow Ave
Hoboken, NJ 07030-4175
Phone (201) 659-3311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA39279NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients
Garden State Healthcare Associates, LLC Cardiovascular Disease CurrentSince May 22, 2012 Accepting new patients
St. Mary Cardiology Associates Cardiovascular Disease PastSince Dec 9, 2008 Accepting new patients

Locations

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

Interoperability endpoints

  • Direct secure messaging: anthony.kyreakakis@direct.hobokenumc.md

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1659382349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 WILLOW AVENUE",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "07030",
            "telephone_number": "201-659-3311",
            "fax_number": "201-795-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 WILLOW AVE",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070304175",
            "telephone_number": "201-659-3311",
            "fax_number": "201-795-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYREAKAKIS",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "MA39279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1387405",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTHONY",
            "last_name": "KYREAKAKIS",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hoboken, NJ

Sources for this page

Verify at the official NPI Registry.