Bloomfield Vein & Vascular PLLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

BLOOMFIELD VEIN & VASCULAR PLLC

Practice address

43700 Woodward Ave Ste 207
Bloomfield Hills, MI 48302-5061

Phone

(419) 794-1006

Fax

(419) 873-6599

NPI assigned

Mar 2, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Diego Hernandez, M.DNPI 1356360143

Title

Owner

Phone

(419) 794-1006

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diego Hernandez, M.D.

  • Vascular Surgery Physician
  • Bloomfield Hills, MI
  • NPI 1356360143
  Medicare reassignment NPD Authorized official
• Jessica Long, NP

  • Nurse Practitioner
  • Shelby TWP, MI
  • NPI 1922519958
  Medicare reassignment NPD
• Natalie Gabrielle Marcus, FNP-BC

  • Family Nurse Practitioner
  • West Bloomfield, MI
  • NPI 1730603903
  Medicare reassignment NPD

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1013309988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43700 WOODWARD AVE STE 207",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025061",
            "telephone_number": "419-794-1006",
            "fax_number": "419-873-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43700 WOODWARD AVE STE 207",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025061",
            "telephone_number": "419-794-1006",
            "fax_number": "419-873-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD VEIN & VASCULAR PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-794-1006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bloomfield Oral & Maxillofacial Surgery PLLC (Bloomfield Oral Surgery)
• Bloomfield Oral & Maxillofacial Surgery, P.C.
• Bloomfield Professional Pharmacy (Oakland Hills Pharmacy)
• Bloomfield RX LLC
• Bloomfield Urgent Care PLLC
• Christian Bogner, M.D.
• Paul J Bohdiewicz, MD
• Kristen Lee Boike, MS, LPC
• Boloms Transport Services, LLC
• Camille Bolton, LLPC

• Vascular Surgery Physician in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Vascular Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.