Organization Active NPI

Children's Heart Clinic

  • Pediatric Cardiology Physician
  • Glendale, CA
National Provider Identifier
1710484399
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
145986 Issued in CA
Legal business name
CHILDREN'S HEART CLINIC
Doing business as
Children's Heart Clinic
Practice address
411 N Central Ave Ste 250
Glendale, CA 91203-2061
Phone
(818) 839-7101
NPI assigned
Apr 10, 2018
Last updated
Apr 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Authorized official

Name
Dr. Georgios A. Hartas, MDNPI 1750598025
Title
President
Phone
(571) 405-4012

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
Pediatric Cardiology Physician 2080P0202X 145986 CA Primary

Addresses

Primary practice location

411 N Central Ave Ste 250
Glendale, CA 91203-2061

Mailing address

12025 New Dominion Pkwy Apt 307
Reston, VA 20190-6267
Phone (571) 405-4012

Other names 1

  • Children's Heart Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210526001446 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3476952383 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Locations

411 N Central Ave
Ste 250
Glendale, CA 91203
Phone (818) 240-2270

Practitioners & affiliated clinicians

Practitioners 1

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": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1710484399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12025 NEW DOMINION PKWY APT 307",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201906267",
            "telephone_number": "571-405-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N CENTRAL AVE STE 250",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032061",
            "telephone_number": "818-839-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HEART CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "HARTAS",
        "authorized_official_first_name": "GEORGIOS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "571-405-4012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "145986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Heart Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.