MEDICARE: PETER ROUVELAS, M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	193878-1	NY
2	207RC0000X	Cardiovascular Disease Physician	193878-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2325878	OTHER	NY	AETNA/USHC HMO INTERN MED
2	901308102	OTHER	NY	AMERI HEALTH
3	11N8621	OTHER	NY	NEIGHBORHOOD
4	202049	OTHER	NY	USFHP
5	35285	OTHER	NY	MASTERCARE
6	161188	OTHER	NY	ELDERPLAN
7	17J031	OTHER	NY	BLUE CROSS/BLUE SHIELD
8	1P0045	OTHER	NY	PHS
9	2327011	OTHER	NY	AETNA/USHC HMO CARDIOLOGY
10	6004974	OTHER	NY	GHI
11	7817826005	OTHER	NY	CIGNA
12	7969061	OTHER	NY	AETNA/USHC PPO/POS
13	00000093064	OTHER	NY	BETTER HEALTH PPO
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	102998	OTHER	NY	AETNA/USCH (PCP ONLY)
16	193878-NY	OTHER	NY	199 SEIU
17	1P0045	OTHER	NY	TOUCHSTONE
18	RP3878	OTHER	NY	ATLANTIS

General Provider Information

NPI Number	:	1699881383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETER ROUVELAS, M.D., P.C.

Provider Business Mailing Address
First Line	:	8115 7TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-2804
Country	:	US
Telephone Number	:	718-833-5303
Fax Number	:	718-833-5304

Provider Business Practice Location Address
First Line	:	8115 7TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-2804
Country	:	US
Telephone Number	:	718-833-5303
Fax Number	:	718-833-5304

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PETER ROUVELAS
Credential	:	M.D.
Telephone Number	:	646-897-6694

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	04/02/2013

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