Organization Active NPI

Pinnacle Vascular Institute LLC

  • Vascular Surgery Physician
  • New Brunswick, NJ
National Provider Identifier
1063216711
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
PINNACLE VASCULAR INSTITUTE LLC
Practice address
303 George St Ste 105
New Brunswick, NJ 08901-2009
Phone
(732) 735-0987
Fax
(732) 605-5850
NPI assigned
Apr 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
David J O'Connor, MDNPI 1063736510
Title
Owner
Phone
(732) 735-0987

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 PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

303 George St Ste 105
New Brunswick, NJ 08901-2009

Mailing address

303 George St Ste 105
New Brunswick, NJ 08901-2009
Phone (732) 735-0987

Other practice location 1

43 Yawpo Ave Ste 7
Oakland, NJ 07436-2717
Phone (732) 735-0987

Other practice location 2

10 Industrial Way E Ste 103
Eatontown, NJ 07724-3332
Phone (732) 735-0987

Other practice location 3

667 Eagle Rock Ave
West Orange, NJ 07052-2177
Phone (732) 735-0987

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250408000029 NJ Part B Supplier - Clinic/Group Practice 2860916277 Receives reassigned benefits from 1 practitioner
Practice locations: Eatontown, NJ; Holmdel, NJ; New Brunswick, NJ; Oakland, NJ; West Orange, NJ

National Provider Directory

National Provider Directory

Locations

10 Industrial Way E
Ste 103
Eatontown, NJ 07724
Phone (732) 735-0987

Practitioners & affiliated clinicians

Practitioners 1

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": "1743552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1063216711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 GEORGE ST STE 105",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012009",
            "telephone_number": "732-735-0987",
            "fax_number": "732-605-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 GEORGE ST STE 105",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012009",
            "telephone_number": "732-735-0987",
            "fax_number": "732-605-5850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 Yawpo Ave Ste 7",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "NJ",
            "postal_code": "074362717",
            "country_code": "US",
            "telephone_number": "732-735-0987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Industrial Way E Ste 103",
            "address_purpose": "LOCATION",
            "city": "Eatontown",
            "state": "NJ",
            "postal_code": "077243332",
            "country_code": "US",
            "telephone_number": "732-735-0987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "667 Eagle Rock Ave",
            "address_purpose": "LOCATION",
            "city": "West Orange",
            "state": "NJ",
            "postal_code": "070522177",
            "country_code": "US",
            "telephone_number": "732-735-0987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PINNACLE VASCULAR INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-735-0987",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "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": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.