Dorothy Myridakis, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

25MA05860500 Issued in NJ

Practice address

1 Broadway
Suite 203
Elmwood Park, NJ 07407-1842

Phone

(973) 569-6250

Fax

(973) 569-6270

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Cardiovascular Disease (Cardiology)Also: Pediatric Medicine

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pediatric Cardiology Associates PCGroup PAC ID 5799768875, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dorothy.myridakis@pedcard.eclinicaldirectplus.com

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

• Pediatric Cardiology Associates PC

  • Specialist
  • Elmwood Park, NJ
  • NPI 1295873255
  Medicare reassignment Care Compare group NPD
• St Josephs Medical Group PC

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1205425519
  Medicare reassignment NPD
• Trustees of Columbia University in the Department of Otolaryngology

  • Specialist
  • New York, NY
  • NPI 1801074315
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1740335405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROADWAY",
            "address_2": "SUITE 203",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071842",
            "telephone_number": "973-569-6250",
            "fax_number": "973-569-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROADWAY",
            "address_2": "SUITE 203",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071842",
            "telephone_number": "973-569-6250",
            "fax_number": "973-569-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRIDAKIS",
        "first_name": "DOROTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA058605",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NJ",
            "license": "25MA05860500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5518300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neda Nazem, MS,BC,AS
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• New Jersey CVS Pharmacy LLC
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• Emily Nowosielecki, MS, RDN

• Pediatric Cardiology Physician in Elmwood Park, NJ
• Providers in Elmwood Park, NJ by specialty
• Pediatric Cardiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.