NPIMap

Organization Active NPI

Vascular Surgical Associates, PC

  • Vascular Surgery Physician
  • Marietta, GA
National Provider Identifier
1114083532
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR SURGICAL ASSOCIATES, PC
Practice address
61 Whitcher St NE Ste 2100
Marietta, GA 30060-1179
Phone
(770) 423-0595
Fax
(770) 423-0598
NPI assigned
Dec 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Rachel Reyes
Title
CPC
Phone
(678) 388-1621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

61 Whitcher St NE Ste 2100
Marietta, GA 30060-1179

Mailing address

60 Chastain Center Blvd NW Ste 66
Kennesaw, GA 30144-5598
Phone (770) 423-0595

Other practice location 1

6095 Professional Pkwy Ste B203
Douglasville, GA 30134-5608
Phone (770) 423-0595

Other practice location 2

3747 Roswell Rd Ste 316
Marietta, GA 30062-6227
Phone (678) 626-5420

Other practice location 3

2041 Mesa Valley Way Ste 185
Austell, GA 30106-6856
Phone (770) 944-8315

Other practice location 4

130 Riverstone Ter Ste 100
Canton, GA 30114-1702
Phone (770) 479-4800

Other practice location 5

148 Bill Carruth Pkwy Ste 380
Hiram, GA 30141-3763
Phone (770) 874-0703

Other practice location 6

962 Joe Frank Harris Pkwy SE Ste 202
Cartersville, GA 30120-2154
Phone (770) 423-0595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040625000667 GA Part B Supplier - Clinic/Group Practice 6709862212 Receives reassigned benefits from 24 practitioners
Practice locations: Duluth, GA; Hiram, GA; Lawrenceville, GA; Marietta, GA; Cumming, GA; Douglasville, GA; Atlanta, GA; Austell, GA…
O20170331002080 GA DME Supplier - Physician - General PracticeDME Supplier - Prosthetic Personnel 6709862212 Practice locations: Marietta, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2157079Vascular Surgical Associates, PC61 Whitcher Street, Suite 3150, Marietta, GA 30060Certificate of waiverOct 29, 2026
11D2302954Vascular Surgical Associates, PC6095 Professional Parkway, Suite B203, Douglasville, GA 30134Certificate of waiverApr 17, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Vascular Surgical Associates PC61 Whitcher St NE, Marietta, GA 30060-1180(770) 423-0595 Limb Prostheses|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

450 Northside Cherokee Blvd
Ste 300
Canton, GA 30115

130 Riverstone Ter
Ste 100
Canton, GA 30114
Phone (770) 479-4800

690 Joe Frank Harris Pkwy SE
Cartersville, GA 30120

6095 Professional Pkwy
Ste B203
Douglasville, GA 30134
Phone (770) 947-7747

6095 Professional Pkwy
Ste 203
Douglasville, GA 30134

61 Whitcher St NE
Ste 2120
Marietta, GA 30060
Phone (770) 544-1145

1505 Stone Bridge Pkwy
Woodstock, GA 30189
Phone (770) 926-6520

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1114083532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CHASTAIN CENTER BLVD NW STE 66",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445598",
            "telephone_number": "770-423-0595",
            "fax_number": "770-423-0598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE STE 2100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601179",
            "telephone_number": "770-423-0595",
            "fax_number": "770-423-0598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6095 Professional Pkwy Ste B203",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301345608",
            "country_code": "US",
            "telephone_number": "770-423-0595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3747 Roswell Rd Ste 316",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300626227",
            "country_code": "US",
            "telephone_number": "678-626-5420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2041 Mesa Valley Way Ste 185",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301066856",
            "country_code": "US",
            "telephone_number": "770-944-8315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Riverstone Ter Ste 100",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301141702",
            "country_code": "US",
            "telephone_number": "770-479-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "148 Bill Carruth Pkwy Ste 380",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301413763",
            "country_code": "US",
            "telephone_number": "770-874-0703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "962 Joe Frank Harris Pkwy SE Ste 202",
            "address_purpose": "LOCATION",
            "city": "Cartersville",
            "state": "GA",
            "postal_code": "301202154",
            "country_code": "US",
            "telephone_number": "770-423-0595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VASCULAR SURGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "CPC",
        "authorized_official_telephone_number": "678-388-1621"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.