Organization Active NPI

New York Cardiovascular Medicine PLLC

  • Cardiovascular Disease Physician
  • Rego Park, NY
National Provider Identifier
1700914033
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
216625 Issued in NY
Legal business name
NEW YORK CARDIOVASCULAR MEDICINE PLLC
Practice address
65-36 99TH Street
Rego Park, NY 11374
Phone
(718) 459-0700
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Authorized official

Name
Dr. Dima Teitelman, MDNPI 1548285497
Title
Managing Member
Phone
(917) 579-2343

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 216625 NY Primary

Addresses

Primary practice location

65-36 99TH Street
Rego Park, NY 11374

Mailing address

6536 99TH St
Rego Park, NY 11374-4358
Phone (718) 459-0700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080118000691 NY Part B Supplier - Clinic/Group Practice 0547341224 Receives reassigned benefits from 3 practitioners
Practice locations: Forest Hills, NY; Mount Vernon, NY; Rego Park, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1700914033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6536 99TH ST",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744358",
            "telephone_number": "718-459-0700",
            "fax_number": "718-459-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-36 99TH STREET",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-459-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK CARDIOVASCULAR MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "TEITELMAN",
        "authorized_official_first_name": "DIMA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "917-579-2343",
        "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": "216625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.