Active NPI
Preferred Vascular Services Akron, LLC
- Vascular Surgery Physician
- Munroe Falls, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- Legal business name
- PREFERRED VASCULAR SERVICES AKRON, LLC
- Practice address
- 43 S Main St Ste 1
Munroe Falls, OH 44262-1635 - Phone
- (234) 349-8100
- Fax
- (239) 597-2313
- NPI assigned
- Jun 30, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Boyd Baldock
- Title
- Officer and Authorized Offiical
- Phone
- (615) 234-5954
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | |||
| Vascular Surgery Physician | 2086S0129X | Primary |
Addresses
Primary practice location
43 S Main St Ste 1
Munroe Falls, OH 44262-1635
Mailing address
9140 Corsea del Fontana Way
Naples, FL 34109-4397
Phone (239) 597-2010
Other practice location 1
43 S Main St Ste 2
Munroe Falls, OH 44262-1635
Phone (234) 349-8100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250108003948 | OH | Part B Supplier - Clinic/Group Practice | 1850829565 |
Receives reassigned benefits from 3 practitioners Practice locations: Munroe Falls, OH |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2289661 | Preferred Vascular Services Akron, LLC | Certificate of waiver | Sep 12, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Vascular Surgery Physician
- Beachwood, OH
- NPI 1346734365
Member Of
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Vascular Surgery Physician
- Middleburg Heights, OH
- NPI 1437110632
OH, Vascular Surgery
-
- Vascular & Interventional Radiology Physician
- Rochester, MN
- NPI 1427412014
OH, Vascular & Interventional Radiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688083200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1770163200000",
"number": "1114604105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9140 CORSEA DEL FONTANA WAY",
"city": "NAPLES",
"state": "FL",
"postal_code": "341094397",
"telephone_number": "239-597-2010",
"fax_number": "239-597-2313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 S MAIN ST STE 1",
"city": "MUNROE FALLS",
"state": "OH",
"postal_code": "442621635",
"telephone_number": "234-349-8100",
"fax_number": "239-597-2313"
}
],
"practiceLocations": [
{
"address_1": "43 S Main St Ste 2",
"address_purpose": "LOCATION",
"city": "Munroe Falls",
"state": "OH",
"postal_code": "442621635",
"country_code": "US",
"telephone_number": "234-349-8100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "PREFERRED VASCULAR SERVICES AKRON, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-30",
"last_updated": "2026-02-04",
"certification_date": "2026-02-04",
"status": "A",
"authorized_official_last_name": "BALDOCK",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "BOYD",
"authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFIICAL",
"authorized_official_telephone_number": "615-234-5954"
},
"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": [],
"other_names": []
}
Other providers in Munroe Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.