NPIMap

Organization Active NPI

S J H Cardiac Catheterization Associates PC

  • Cardiovascular Disease Physician
  • Liverpool, NY
National Provider Identifier
1699761197
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
S J H CARDIAC CATHETERIZATION ASSOCIATES PC
Practice address
4820 W Taft Rd
Suite 209
Liverpool, NY 13088-2800
Phone
(315) 448-6215
Fax
(315) 234-4416
NPI assigned
Sep 21, 2005
Last updated
Mar 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Authorized official

Name
Ali Al-Mudamgha, MD
Title
President
Phone
(315) 234-0906

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X NU
Interventional Cardiology Physician 207RI0011X NU

Addresses

Primary practice location

4820 W Taft Rd
Suite 209
Liverpool, NY 13088-2800

Mailing address

4820 W Taft Rd
Suite 209
Liverpool, NY 13088-2800
Phone (315) 448-6215

Other identifiers 1

IdentifierTypeStateIssuer
02130050MedicaidNY

National Provider Directory

National Provider Directory

Locations

4820 W Taft Rd
Ste 201
Liverpool, NY 13088
Phone (315) 234-0906

4900 Broad Rd
#2H
Syracuse, NY 13215
Phone (315) 299-5313

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1699761197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 W TAFT RD",
            "address_2": "SUITE 209",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130882800",
            "telephone_number": "315-448-6215",
            "fax_number": "315-234-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 W TAFT RD",
            "address_2": "SUITE 209",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130882800",
            "telephone_number": "315-448-6215",
            "fax_number": "315-234-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S J H CARDIAC CATHETERIZATION ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "AL-MUDAMGHA",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-234-0906",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02130050",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.