NPIMap

Organization Active NPI

Vascular Institute of Cleveland, LLC

  • Vascular Surgery Physician
  • Garfield Heights, OH
National Provider Identifier
1033743240
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR INSTITUTE OF CLEVELAND, LLC
Practice address
12575 Rockside Rd Ste 102
Garfield Heights, OH 44125-4571
Phone
(216) 839-0692
Fax
(805) 790-0010
NPI assigned
Feb 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
Sara Arredondo
Title
Authorized Official
Phone
(216) 839-0692

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

12575 Rockside Rd Ste 102
Garfield Heights, OH 44125-4571

Mailing address

18375 Ventura Blvd Ste 554
Tarzana, CA 91356-4218
Phone (216) 839-0692

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL office

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200421002328 OH Part B Supplier - Clinic/Group Practice 1951731686 Receives reassigned benefits from 9 practitioners
Practice locations: Garfield Heights, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1033743240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18375 VENTURA BLVD STE 554",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564218",
            "telephone_number": "216-839-0692",
            "fax_number": "805-790-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12575 ROCKSIDE RD STE 102",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441254571",
            "telephone_number": "216-839-0692",
            "fax_number": "805-790-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR INSTITUTE OF CLEVELAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "ARREDONDO",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "216-839-0692"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "office",
            "affiliation": "N",
            "address_1": "12575 Rockside Rd Ste 102",
            "city": "Garfield Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441254571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Garfield Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.