NPIMap

Organization Active NPI

Valley Vascular Associates, Inc

  • Vascular Surgery Physician
  • Van Nuys, CA
National Provider Identifier
1033177902
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A66104 Issued in CA
Legal business name
VALLEY VASCULAR ASSOCIATES, INC
Practice address
16917 Enadia Way
Van Nuys, CA 91406-3602
Phone
(818) 401-1010
Fax
(818) 401-1212
NPI assigned
May 2, 2006
Last updated
Jun 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Authorized official

Name
Dr. Ihab Naim Aziz, MDNPI 1700873593
Title
President
Phone
(818) 401-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A66104 CA
Vascular Surgery Physician 2086S0129X A66104 CA Primary

Addresses

Primary practice location

16917 Enadia Way
Van Nuys, CA 91406-3602

Mailing address

16917 Enadia Way
Van Nuys, CA 91406-3602
Phone (818) 401-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060621000141 CA Part B Supplier - Clinic/Group Practice 2163434861 Receives reassigned benefits from 5 practitioners
Practice locations: Burbank, CA; Lancaster, CA; Santa Clarita, CA; Van Nuys, CA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/299f89be-f85c-4368-87fb-a971e7696d7c/

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1033177902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16917 ENADIA WAY",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063602",
            "telephone_number": "818-401-1010",
            "fax_number": "818-401-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16917 ENADIA WAY",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063602",
            "telephone_number": "818-401-1010",
            "fax_number": "818-401-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY VASCULAR ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "AZIZ",
        "authorized_official_first_name": "IHAB",
        "authorized_official_middle_name": "NAIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-401-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A66104",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A66104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.