Elysium Aesthetics and Vein Care, Inc

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

25MA08769000 Issued in NJ

Legal business name

ELYSIUM AESTHETICS AND VEIN CARE, INC

Practice address

400 State Route 17
Ridgewood, NJ 07450

Phone

(518) 852-8114

Fax

(866) 339-2822

NPI assigned

Mar 30, 2016

Organization subpart

No

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

Authorized official

Name

Dr. David Singh, MD

Title

Owner

Phone

(518) 852-8114

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13195/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1952764862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 BEECHWOOD RD",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "07649",
            "telephone_number": "518-852-8114",
            "fax_number": "866-339-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 STATE ROUTE 17",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "518-852-8114",
            "fax_number": "866-339-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYSIUM AESTHETICS AND VEIN CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-06-03",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-852-8114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA08769000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0242039",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Vascular & Interventional Radiology Physician in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Vascular & Interventional Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; 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.