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PREMIERE CARDIOLOGY PLLC
NPI 1184858151
Internal Medicine - Cardiovascular Disease in Bay Shore, NY

Active since May 06, 2009
1916 UNION BLVD, BAY SHORE, NY 11706(631) 666-2291(631) 666-2283 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 8, 2024, May 8, 2020 (2 updates tracked since 2020).

About Premiere Cardiology Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIERE CARDIOLOGY PLLC (NPI 1184858151) is a healthcare organization registered as a cardiovascular disease in Bay Shore, New York and active in the NPI registry since May 2009. The organization lists Laura Coudrey, President, as its authorized official.

NPPES Registry Identity

NPI1184858151
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NamePREMIERE CARDIOLOGY PLLC
Location Address1916 UNION BLVDBay Shore, NY 11706-7921
Mailing Address1916 Union BlvdBay Shore, NY 11706-7921 · (631) 666-2291 · Fax (631) 666-2283
Phone(631) 666-2291
Fax(631) 666-2283
Organization SubpartNo
Authorized OfficialLaura CoudreyPresident · (631) 666-2290
Enumeration DateMay 6, 2009
Last NPPES UpdateMay 8, 20242 updates tracked since enumeration
NPPES CertifiedMay 8, 2024
✔ NPI 1184858151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in NY · 200075
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
1916 UNION BLVD, Bay Shore, NY 11706
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premiere Cardiology Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to Premiere Cardiology PLLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Cardiovascular Disease (Cardiology)6
Nurse Practitioner3
Internal Medicine1
Interventional Cardiology1

Clinicians, nearest first (11)

Laura Lennon, M.D.
Cardiovascular Disease (Cardiology)
NPI 1477593978
1916 UNION BLVD
Bay Shore, NY 11706
(631) 666-2290
✔ PECOS✔ Accepts MedicareSame address
Janaira Tucker, FNP
Nurse Practitioner
NPI 1245067594
1916 UNION BLVD
Bay Shore, NY 11706
(516) 928-9202
✔ PECOSSame address
Alex Vidal, M.D.
Cardiovascular Disease (Cardiology)
NPI 1336361385
1916 UNION BLVD. DEPARTMENT OF CARDIOLOGY
Bayshore, NY 11706
(631) 666-2290
✔ PECOSSame address
Gabriel Wagman, M.D.
Cardiovascular Disease (Cardiology)
NPI 1487989190
1916 UNION BLVD
Bay Shore, NY 11706
(631) 666-2290
✔ PECOSSame address
Yasmine Romeus
Nurse Practitioner
NPI 1184108433
158 E MAIN ST
Bay Shore, NY 11706
(631) 665-5639
✔ PECOS✔ Accepts Medicare0.3 mi
Marie Desvarieux, M.D., M.S.
Cardiovascular Disease (Cardiology)
NPI 1063525046
3 E MAIN ST
Bay Shore, NY 11706
(631) 666-2290
✔ PECOS✔ Accepts Medicare1.5 mi
Shahram Hormozi, M.D.
Cardiovascular Disease (Cardiology)
NPI 1215916721
515 ROUTE 111 2ND FLOOR
Hauppauge, NY 11788
(631) 224-1819
✔ PECOS✔ Accepts Medicare7.4 mi
Stephanie Keller, FNP
Nurse Practitioner
NPI 1578366191
11 GLEN HOLLOW DR APT D37
Holtsville, NY 11742
(631) 521-5976
✔ PECOS✔ Accepts Medicare12 mi
Steven Blumenthal, MD
Internal Medicine
NPI 1568441921
98 WOODCHUCK HOLLOW RD
Cold Spring Harbor, NY 11724
(516) 499-3964
✔ PECOS14 mi
Wei Li, MD
Cardiovascular Disease (Cardiology)
NPI 1780831743
13237 41ST RD STE C03
Flushing, NY 11355
(347) 618-1636
✔ PECOS✔ Accepts Medicare31 mi
Michael Manolios, M.D.
Interventional Cardiology
NPI 1700913076
1112 SOUTH AVE STE B
Staten Island, NY 10314
(718) 761-8800
✔ PECOS✔ Accepts Medicare50 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premiere Cardiology PLLC's NPI number?

The NPI number for Premiere Cardiology PLLC is 1184858151. It was assigned to this organization in the NPPES registry on May 6, 2009.

Where is Premiere Cardiology PLLC located?

Premiere Cardiology PLLC is located at 1916 Union Blvd, Bay Shore, NY 11706. The listed phone number is (631) 666-2291.

What is Premiere Cardiology PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Premiere Cardiology PLLC enrolled in Medicare?

Yes. Premiere Cardiology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premiere Cardiology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 4 Medicare specialties reassign their Medicare billing to Premiere Cardiology PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Cardiovascular Disease (Cardiology) (6), Nurse Practitioner (3) and Internal Medicine (1). Of these, 4 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Premiere Cardiology PLLC was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.