Vascular Institute of Arizona PLLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

VASCULAR INSTITUTE OF ARIZONA PLLC

Practice address

21321 E Ocotillo Rd Ste 125
Queen Creek, AZ 85142-5995

Phone

(480) 936-7722

Fax

(480) 936-7723

NPI assigned

May 24, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Praveen C Balraj, MD

Title

Member Manager

Phone

(480) 936-7722

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIJFCD
• FHIR API: https://fhir4.healow.com/fhir/r4/IFFCCD

Practitioners 2

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

• Praveen Chandar Balraj, MD

  • Vascular Surgery Physician
  • Queen Creek, AZ
  • NPI 1447562640
  Medicare reassignment NPD
• Katherine E Denison, AGACNP

  • Acute Care Nurse Practitioner
  • Gilbert, AZ
  • NPI 1396426292
  Medicare reassignment NPD

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1093380941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 S ALMA SCHOOL RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852867076",
            "telephone_number": "480-936-7722",
            "fax_number": "480-936-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 125",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425995",
            "telephone_number": "480-936-7722",
            "fax_number": "480-936-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR INSTITUTE OF ARIZONA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "BALRAJ",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "480-936-7722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esperanza H. Van Den Boom, SPEECH PATHOLOGIST
• Eric Bradford Vanausdal, OD
• Vance Physical Therapy, LLC
• Noel I Vandyke
• Vasco Healthcare Inc
• Michael Vergason, D.O.
• Vibrant Family Chiropractic, LLC
• Cathrin Vietmeier
• Andrea Villalobos, RBT
• Michelle T Villanueva, DDS

• Vascular Surgery Physician in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Vascular Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.