Organization Active NPI

Laurelton Heart Specialist P.C.

  • Cardiovascular Disease Physician
  • Laurelton, NY
National Provider Identifier
1679769152
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
202443 Issued in NY
Legal business name
LAURELTON HEART SPECIALIST P.C.
Practice address
22414 Merrick Blvd
Laurelton, NY 11413-2023
Phone
(718) 949-9400
Fax
(718) 228-3636
NPI assigned
Sep 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Authorized official

Name
Dr. Olakunle Akinboboye, MDNPI 1780632844
Title
President
Phone
(718) 949-9400

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: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 202443 NY Primary

Addresses

Primary practice location

22414 Merrick Blvd
Laurelton, NY 11413-2023

Mailing address

PO Box 29
Roslyn, NY 11576-0029
Phone (718) 949-9400

Other names 1

  • strong health medical group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040223000907 NY Part B Supplier - Clinic/Group Practice 1355248030 Receives reassigned benefits from 4 practitioners
Practice locations: Rosedale, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1679769152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115760029",
            "telephone_number": "718-949-9400",
            "fax_number": "718-228-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22414 MERRICK BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132023",
            "telephone_number": "718-949-9400",
            "fax_number": "718-228-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURELTON HEART SPECIALIST P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "AKINBOBOYE",
        "authorized_official_first_name": "OLAKUNLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-949-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "202443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "strong health medical group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurelton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.