Organization Active NPI

Cardiovascular Consultant of New York, P.C.

  • Interventional Cardiology Physician
  • New York, NY
National Provider Identifier
1972993913
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
CARDIOVASCULAR CONSULTANT OF NEW YORK, P.C.
Practice address
715 W 170TH St Ste LH
New York, NY 10032-2907
Phone
(212) 781-3722
Fax
(212) 781-3695
NPI assigned
Jan 29, 2015
Last updated
Feb 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Dr. Alvaro Jose Dominguez, M.D.NPI 1891806881
Title
President
Phone
(917) 325-1954

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU
Interventional Cardiology Physician 207RI0011X NU Primary

Addresses

Primary practice location

715 W 170TH St Ste LH
New York, NY 10032-2907

Mailing address

715 W 170TH St Ste LH
New York, NY 10032-2907
Phone (212) 781-3722

Other practice location 1

7401 4th Ave Apt A1
Brooklyn, NY 11209-2542
Phone (718) 836-0009

Other identifiers 2

IdentifierTypeStateIssuer
04126436MedicaidNY
01241318MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150629000041 NY Part B Supplier - Clinic/Group Practice 6709198138 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY; Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1972993913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 W 170TH ST STE LH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322907",
            "telephone_number": "212-781-3722",
            "fax_number": "212-781-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W 170TH ST STE LH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322907",
            "telephone_number": "212-781-3722",
            "fax_number": "212-781-3695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7401 4th Ave Apt A1",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112092542",
            "country_code": "US",
            "telephone_number": "718-836-0009",
            "fax_number": "718-836-3695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARDIOVASCULAR CONSULTANT OF NEW YORK, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-325-1954",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04126436",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01241318",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.