Victory Medical Associates PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

VICTORY MEDICAL ASSOCIATES PC

Practice address

129 Central Park N
New York, NY 10026-4201

Phone

(914) 331-0820

Fax

(888) 443-9088

NPI assigned

Apr 23, 2019

Last updated

Aug 12, 2022By 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

Yaakov Grun

Title

Manager

Phone

(845) 395-4071

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 15

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.

• Salem El Mizzawi

  • Physician Assistant
  • Poughkeepsie, NY
  • NPI 1871077610
  Medicare reassignment Care Compare group NPD
• Jay Lachman, NP

  • Family Nurse Practitioner
  • Cedarhurst, NY
  • NPI 1437760972
  Medicare reassignment Care Compare group NPD
• David Mobley, M.D.

  • Vascular & Interventional Radiology Physician
  • New York, NY
  • NPI 1457632580
  Medicare reassignment Care Compare group NPD
• Daniel Novick, M.D.

  • Vascular & Interventional Radiology Physician
  • Brooklyn, NY
  • NPI 1265829527
  Medicare reassignment Care Compare group NPD
• Richard J Daniels, MD

  • Vascular Surgery Physician
  • Toms River, NJ
  • NPI 1417905043

  NY

  Medicare reassignment Care Compare group NPD
• Sarah Joel Kantharia, M.D.

  • Vascular & Interventional Radiology Physician
  • Washington, DC
  • NPI 1881039253

  NY

  Medicare reassignment Care Compare group NPD
• Michael Joseph Velez

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
  • NPI 1851284186
  Medicare reassignment Care Compare group
• Teresa Altawil, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Southfield, MI
  • NPI 1548937162

  NY

  Medicare reassignment NPD
• Brooke Mercer, PA-C

  • Physician Assistant
  • New York, NY
  • NPI 1972994986
  Medicare reassignment
• Bryanna Colleen Kelly, DNP, AGNP-BC

  • Adult Health Nurse Practitioner
  • Staten Island, NY
  • NPI 1457968943
  NPD
• Amit Rajendra Shah, M.D.

  • Vascular Surgery Physician
  • Massapequa Park, NY
  • NPI 1396067682
  NPD
• Guruprasad Srinivas, M.D.

  • Interventional Cardiology Physician
  • Manhasset, NY
  • NPI 1821318742
  NPD (past)

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1902460124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 CENTRAL PARK N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100264201",
            "telephone_number": "914-331-0820",
            "fax_number": "888-443-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 CENTRAL PARK N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100264201",
            "telephone_number": "914-331-0820",
            "fax_number": "888-443-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-23",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "GRUN",
        "authorized_official_first_name": "YAAKOV",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "845-395-4071"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://www.practicefusion.com/",
            "affiliation": "N",
            "address_1": "129 Central Park N",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100264201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Victoria Minior MD PLLC
• Victoria Moran Physical Therapy PLLC
• Victoria Physical Medicine PC
• Jacqueline Victoria-Kline, LMSW
• Daniel Victorio, MD
• Vida Family Services, Inc.
• Vida Pharmacy, Inc.
• Alana Marie Vidal, MS, CF-SLP, TSSLD
• Grecia Milagros Vidal
• Laura V Vidal, LCSW

• Cardiovascular Disease Physician in New York, NY
• Providers in New York, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.