NPIMap

Organization Active NPI

Center for Vein Restoration MD LLC

  • Vascular Surgery Physician
  • Fairfax, VA
National Provider Identifier
1114749439
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
CENTER FOR VEIN RESTORATION MD LLC
Practice address
8316 Arlington Blvd Ste 515
Fairfax, VA 22031-5216
Phone
(855) 830-8346
Fax
(240) 473-4321
NPI assigned
Oct 28, 2024
Last updated
Oct 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Lorena Thomas
Title
Credentialing Manager
Phone
(815) 254-1761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

8316 Arlington Blvd Ste 515
Fairfax, VA 22031-5216

Mailing address

7474 Greenway Center Dr Ste 1000
Greenbelt, MD 20770-3500
Phone (815) 254-1761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251208003348 VA DME Supplier - Physician - Thoracic Surgery 8729022736 Practice locations: Fairfax, VA

National Provider Directory

National Provider Directory
Tax ID family
Sanjiv Lakhanpal MD36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1114749439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7474 GREENWAY CENTER DR STE 1000",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703500",
            "telephone_number": "815-254-1761",
            "fax_number": "240-473-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD STE 515",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315216",
            "telephone_number": "855-830-8346",
            "fax_number": "240-473-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR VEIN RESTORATION MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "LORENA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "815-254-1761"
    },
    "taxonomies": [
        {
            "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 Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.