Premier Vein & Vascular, LLC

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

25MA08003200 Issued in NJ

Legal business name

PREMIER VEIN & VASCULAR, LLC

Practice address

479 RT 520
Ste A203
Marlboro, NJ 07746

Phone

(908) 812-4460

Fax

(732) 263-5029

NPI assigned

Jan 23, 2018

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Isaac H. Tawfik, MDNPI 1073612990

Title

MD., Owner

Phone

(908) 812-4460

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Interoperability endpoints

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

Practitioners 1

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.

• Isaac Tawfik, MD

  • Interventional Cardiology Physician
  • Eatontown, NJ
  • NPI 1073612990
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1114425253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 COUNTY ROAD 520 STE A203",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461087",
            "telephone_number": "908-812-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 RT 520",
            "address_2": "STE A203",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "07746",
            "telephone_number": "908-812-4460",
            "fax_number": "732-263-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER VEIN & VASCULAR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "TAWFIK",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "MD., OWNER",
        "authorized_official_telephone_number": "908-812-4460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NJ",
            "license": "25MA08003200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "25MA08003200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Interventional Cardiology Physician in Marlboro, NJ
• Providers in Marlboro, NJ by specialty
• Interventional Cardiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.