Active Healthcare Medical, PLLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

ACTIVE HEALTHCARE MEDICAL, PLLC

Practice address

100 Duffy Ave Ste 510
Hicksville, NY 11801-3636

Phone

(732) 236-8212

NPI assigned

May 12, 2025

Last updated

May 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ajay Kumar Agarwala, MD

Title

Member

Phone

(732) 236-8212

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1881484764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DUFFY AVE STE 510",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013636",
            "telephone_number": "732-236-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DUFFY AVE STE 510",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013636",
            "telephone_number": "732-236-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE HEALTHCARE MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "AGARWALA",
        "authorized_official_first_name": "AJAY",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "732-236-8212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Hicksville, NY
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• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.