Organization Active NPI

E T Medical PLLC

  • Pediatric Cardiology Physician
  • Corona, NY
National Provider Identifier
1912487588
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
252185 Issued in NY
Legal business name
E T MEDICAL PLLC
Practice address
10211 Roosevelt Ave
Corona, NY 11368-2331
Phone
(718) 898-5200
Fax
(718) 898-1251
NPI assigned
Aug 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Authorized official

Name
Emmanouil Tsounias, MDNPI 1366732992
Title
Owner
Phone
(212) 363-0242

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
Pediatric Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0202X 252185 NY Primary

Addresses

Primary practice location

10211 Roosevelt Ave
Corona, NY 11368-2331

Mailing address

10211 Roosevelt Ave
Corona, NY 11368-2331
Phone (718) 898-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200103002131 NY Part B Supplier - Clinic/Group Practice 7810321536 Receives reassigned benefits from 1 practitioner
Practice locations: Corona, NY

National Provider Directory

National Provider Directory

Locations

10211 Roosevelt Ave
Ste 2
Corona, NY 11368
Phone (718) 902-4301

Practitioners & affiliated clinicians

Practitioners 1

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": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1912487588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10211 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682331",
            "telephone_number": "718-898-5200",
            "fax_number": "718-898-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10211 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682331",
            "telephone_number": "718-898-5200",
            "fax_number": "718-898-1251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E T MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "TSOUNIAS",
        "authorized_official_first_name": "EMMANOUIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-363-0242",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "252185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.