Active NPI
Vivian Akrive Kominos, M.D.
- Cardiovascular Disease Physician
- Freehold, NJ
National Provider Identifier
1780688192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MA46965
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MS068 | Other | OXFORD | |
| 0043373 | Other | NJ | AETNA HMO |
| 0037042 | Other | NJ | GHI PPO |
| 1049711 | Other | NJ | HORIZON NJ HEALTH |
| 4093924 | Other | NJ | AETNA PPO |
| F07150 | Other | HEALTHNET | |
| 060058972 | Other | RR 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
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| MA46965 | NJ | MD | Cardiovascular Disease Physician |
Interoperability endpoints
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2011; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.