OPTIMUM HEART ASSOCIATES PLLC
Complete NPI Record 1588093470
Internal Medicine - Cardiovascular Disease in Brooklyn, NY

NPI Status: Active since November 01, 2013

Contact Information

1946 BATH AVE
BROOKLYN, NY
ZIP 11214
Phone: (718) 360-0760
Fax: (781) 523-2482

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Complete NPI Dataset

This page represents the complete record for NPI 1588093470. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1588093470
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 66 SUGAR MAPLE DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address City Name: ROSLYN
The city name in the location address of the provider being identified.
Provider Business Mailing Address State Name: NY
The State code in the location of the provider being identified.
Provider Business Mailing Address Postal Code: 115763229
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Mailing Address Telephone Number: 7183600760
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address Fax Number: 7815232482
The date the provider was assigned a unique identifier (assigned an NPI).
Provider First Line Business Practice Location Address: 1946 BATH AVE
The date that a record was last updated or changed.
Provider Business Practice Location Address City Name: BROOKLYN
The code designating the provider’s gender if the provider is a person.
Provider Business Practice Location Address State Name: NY
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address Postal Code: 112144704
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7183600760
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 7815232482
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 11/1/2013
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 3/1/2023
The date that a record was last updated or changed.
Authorized Official Last Name: BOTROS
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: AMGAD
The first name of the authorized official.
Authorized Official Title or Position: MD
The title or position of the authorized official.
Authorized Official Telephone Number: 9179072819
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 207RC0000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Authorized Official Credential Text: MD
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 10/21/2022