How to Choose a Cardiologist: Subspecialties, Referrals and What to Check

What cardiologists do and when you are referred

The NUCC Health Care Provider Taxonomy, the code set used in NPI records, describes a cardiovascular disease physician as 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 heart rhythms. In practice, people are often sent to a cardiologist by their primary care clinician to evaluate symptoms, an abnormal test, high blood pressure that is hard to control, or after a hospital stay for a heart problem.

Whether you need that referral for coverage depends on your plan. Medicare.gov's comparison of Original Medicare and Medicare Advantage says that with Original Medicare you usually do not need a referral to see a specialist, while Medicare.gov's HMO page says most Medicare Advantage HMOs require one. Our guide to referrals covers other plan types.

Types of cardiologists

NUCC lists several cardiology codes a physician can register. A profile on this site shows the codes in the physician's NPI record; the codes are chosen by the physician and are a starting point, not proof of training.

General cardiology (cardiovascular disease)

The broad specialty described above. A general cardiologist usually handles the first evaluation, ordering and reading tests and managing long-term heart conditions with medicines and follow-up.

Interventional cardiology

NUCC describes interventional cardiology as an area within cardiology that uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and heart chambers, and uses technical procedures and medications to treat abnormalities. These are the physicians who perform catheter-based procedures such as opening a narrowed artery.

Clinical cardiac electrophysiology

Per NUCC, a field within cardiology involving intricate technical procedures to evaluate heart rhythms and determine treatment for them. Electrophysiologists see patients with rhythm problems and implant or manage devices that control heart rhythm.

Advanced heart failure and transplant cardiology

NUCC describes these specialists as managing patients with advanced heart failure, including those being considered for high-risk heart surgery, heart transplant or mechanical circulatory support, and caring for them before and after.

Which one do you need?

Usually you start with a general cardiologist, who sends you to a subspecialist if needed. If your primary care clinician already suspects a rhythm problem or you were told you need a procedure, ask which kind of cardiologist they recommend. Our taxonomy guide explains how specialty codes work.

Cardiologist or cardiac surgeon

NUCC describes a thoracic surgeon as providing operative and critical care of patients with conditions within the chest, including the surgical care of coronary artery disease and abnormalities of the great vessels and heart valves. These surgeons, often called cardiothoracic or cardiac surgeons, perform operations such as bypass surgery and many valve repairs or replacements. Cardiologists, including interventional cardiologists, treat many of the same conditions with medicines or catheter procedures.

When surgery is recommended, it is reasonable to ask how the decision was made and whether a non-surgical option was considered. Medicare.gov's page on second surgical opinions says that in some cases Part B covers a second opinion before medically necessary surgery that is not an emergency, and a third opinion if the first two differ.

Checking license and board certification

State license

A cardiologist must hold a license in the state where you are treated. The state medical board is the authority on whether it is active and whether there are public disciplinary orders. The FSMB lists every state medical board, and each clinician profile on this site links to the board for the practice state. Our license guide explains how to read a board record.

Board certification

Board certification is voluntary and separate from the license. It is not part of NPI or Medicare records, so neither the NPI Registry nor this site can confirm it. Check it with the board itself: for MD and DO physicians certified by boards in the American Board of Medical Specialties, use Certification Matters; for osteopathic boards, the American Osteopathic Association points patients to the FSMB's DocInfo.org search. Certification can be in cardiovascular disease or in a narrower area, so look at which specialty the board lists.

What CMS data on a profile can and cannot tell you

What it can show

• Medicare assignment: whether CMS lists the cardiologist as accepting assignment. Medicare.gov's assignment page explains that a provider who accepts assignment charges you only the Medicare deductible and coinsurance.
• Services billed to Medicare: the Part B section lists the service codes a cardiologist billed to Original Medicare in past years, such as office visits, heart imaging or procedures, with the number of services and patients.
• Prescribing and industry payments: where present, the Part D section shows drugs prescribed to Medicare patients, and the Open Payments section shows payments that drug and device companies reported to CMS.

What it cannot show

By CMS's methodology, the Part B data cover Original Medicare claims only and leave out any service provided to 10 or fewer patients. A low count or no row does not mean a cardiologist lacks experience with a procedure, and a high count does not measure quality or outcomes. The data do not show hospital privileges, complication rates, wait times or whether the practice accepts new patients. Our guide to Part B data explains each figure.

Medicare coverage you may meet

Two Medicare.gov pages are useful context for heart care:

• Screening: Part B covers cardiovascular screening blood tests for cholesterol, lipid and triglyceride levels once every 5 years, and you pay nothing if the provider accepts assignment.
• Cardiac rehabilitation: Part B covers cardiac rehabilitation programs of exercise, education and counseling for people who have had, among other conditions, a heart attack in the last 12 months, bypass surgery, a heart valve repair or replacement, a coronary angioplasty or stent, or stable chronic heart failure. After the deductible you pay 20% of the Medicare-approved amount, plus a hospital copayment in a hospital outpatient setting.

Questions for the first visit

AHRQ's list of questions to ask is a good base. For a cardiology visit you might also ask:

• What do you think is causing my symptoms, and what tests do you recommend? What will each test tell us?
• Will these tests be done in your office or at a hospital, and what will they cost me?
• Do I need to see a subspecialist, such as an electrophysiologist or interventional cardiologist?
• If you recommend a procedure, what are the alternatives, and how many of these procedures do you perform?
• Which hospital do you work with if I need to be admitted?
• Who should I call with new symptoms between visits, and which symptoms mean I should call 911?

The CDC's page on heart attack symptoms lists chest pain or discomfort; feeling weak, light-headed or faint; pain or discomfort in the jaw, neck, back, arms or shoulders; and shortness of breath, and says to call 911 immediately if you notice them in yourself or someone else. Do not wait for a cardiology appointment.

Bring a list of all your medicines and supplements, recent test results and the names of your other clinicians.

Find a cardiologist near you

On T-MedInfo you can browse clinicians by state and city from the city listings below and open the cardiovascular disease listing for your area, or search by name. On each profile, check the specialty codes, practice address and state board link, and confirm network status with your plan. Our specialist checklist covers the remaining steps.