Individual provider Active NPI

Vivian Akrive Kominos, M.D.

  • Cardiovascular Disease Physician
  • Freehold, NJ
National Provider Identifier
1780688192
Registry record updated May 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MA46965 Issued in NJ
Practice address
901 W Main St Ste 205
Cn5050
Freehold, NJ 07728-2537
Phone
(732) 866-0800
Fax
(732) 866-0018
NPI assigned
Jun 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MA46965 NJ Primary

Addresses

Primary practice location

901 W Main St Ste 205
Cn5050
Freehold, NJ 07728-2537

Mailing address

901 W Main St Ste 205
CN 5050
Freehold, NJ 07728-2537
Phone (732) 866-0800

Other identifiers 7

IdentifierTypeStateIssuer
MS068OtherOXFORD
0043373OtherNJAETNA HMO
0037042OtherNJGHI PPO
1049711OtherNJHORIZON NJ HEALTH
4093924OtherNJAETNA PPO
F07150OtherHEALTHNET
060058972OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 4, 2022 through Mar 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA46965NJMDCardiovascular Disease Physician

Interoperability endpoints

  • Direct secure messaging: vivan.kominos.1@21847.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306627200000",
    "number": "1780688192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST STE 205",
            "address_2": "CN 5050",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-866-0800",
            "fax_number": "732-866-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST STE 205",
            "address_2": "CN5050",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-866-0800",
            "fax_number": "732-866-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMINOS",
        "first_name": "VIVIAN",
        "middle_name": "AKRIVE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2011-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "MA46965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "MS068",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "0043373",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO",
            "identifier": "0037042",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1049711",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4093924",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "F07150",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060058972",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.