Organization Active NPI

Utopia Heartcare PLLC

  • Specialist
  • Oakland Gardens, NY
National Provider Identifier
1750570628
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
160413 Issued in NY
Legal business name
UTOPIA HEARTCARE PLLC
Practice address
21116 Union Tpke
Oakland Gardens, NY 11364-3241
Phone
(718) 217-0500
Fax
(718) 217-0533
NPI assigned
Oct 17, 2007
Last updated
Dec 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Authorized official

Name
Urmila Shivaram, M.D.NPI 1215025473
Title
Sole Owner
Phone
(718) 217-0500

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 160413 NY Primary

Addresses

Primary practice location

21116 Union Tpke
Oakland Gardens, NY 11364-3241

Mailing address

21116 Union Tpke
Oakland Gardens, NY 11364-3241
Phone (718) 217-0500

Other identifiers 1

IdentifierTypeStateIssuer
00947219MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050822001303 NY Part B Supplier - Clinic/Group Practice 4486685245 Receives reassigned benefits from 2 practitioners
Practice locations: Oakland Gardens, NY

National Provider Directory

National Provider Directory

Locations

21116 Union Tpke
Oakland Gdns, NY 11364
Phone (718) 217-0500

Practitioners & affiliated clinicians

Practitioners 2

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": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418342400000",
    "number": "1750570628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21116 UNION TPKE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643241",
            "telephone_number": "718-217-0500",
            "fax_number": "718-217-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21116 UNION TPKE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643241",
            "telephone_number": "718-217-0500",
            "fax_number": "718-217-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTOPIA HEARTCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2014-12-12",
        "status": "A",
        "authorized_official_last_name": "SHIVARAM",
        "authorized_official_first_name": "URMILA",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "718-217-0500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "160413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00947219",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; 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.