Organization Active NPI

Roosevelt Cardiology PC

  • Medical Specialty Clinic/Center
  • Flushing, NY
National Provider Identifier
1891872610
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
201269 Issued in NY
Legal business name
ROOSEVELT CARDIOLOGY PC
Practice address
3660 Main St
Suite 2S
Flushing, NY 11354-6507
Phone
(718) 888-1656
Fax
(718) 886-2336
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Authorized official

Name
Dr. Sungwai Chiu, M.D.NPI 1255418117
Title
Shareholder
Phone
(718) 888-1656

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
Medical Specialty Clinic/Center 261QM2500X 201269 NY Primary

Addresses

Primary practice location

3660 Main St
Suite 2S
Flushing, NY 11354-6507

Mailing address

3660 Main St
Suite 2S
Flushing, NY 11354-6559
Phone (718) 888-1656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070117000059 NY Part B Supplier - Clinic/Group Practice 3375544430 Receives reassigned benefits from 2 practitioners
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

3660 Main St
Ste 2S
Flushing, NY 11354
Phone (718) 888-1656

13621 Roosevelt Ave
Flushing, NY 11354

3660 Main St
Ste 2
Flushing, NY 11354
Phone (718) 888-1656

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346976000000",
    "number": "1891872610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 MAIN ST",
            "address_2": "SUITE 2S",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546559",
            "telephone_number": "718-888-1656",
            "fax_number": "718-886-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 MAIN ST",
            "address_2": "SUITE 2S",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546507",
            "telephone_number": "718-888-1656",
            "fax_number": "718-886-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT CARDIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-09-07",
        "status": "A",
        "authorized_official_last_name": "CHIU",
        "authorized_official_first_name": "SUNGWAI",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "718-888-1656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "201269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; 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.