NPIMap

Organization Active NPI

Vascular Interventional Services, PLLC

  • Vascular Surgery Physician
  • Port Jefferson Sta, NY
National Provider Identifier
1144553025
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
186340 Issued in NY
Legal business name
VASCULAR INTERVENTIONAL SERVICES, PLLC
Practice address
1110B Hallock Ave
Port Jefferson Sta, NY 11776-1210
Phone
(631) 476-9100
Fax
(631) 476-4919
NPI assigned
Sep 10, 2009
Last updated
May 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Authorized official

Name
Dr. Robert M Pollina, M.D.NPI 1013988088
Title
Owner
Phone
(631) 476-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 193100 NY
Vascular Surgery Physician 2086S0129X 221708 NY
Vascular Surgery Physician 2086S0129X 099574 NY
Vascular Surgery Physician 2086S0129X 186340 NY Primary

Addresses

Primary practice location

1110B Hallock Ave
Port Jefferson Sta, NY 11776-1210

Mailing address

1110B Hallock Avenue
Port Jefferson Station, NY 11776-1210
Phone (631) 476-9100

National Provider Directory

National Provider Directory

Locations

1110 Hallock Ave
#B
Port Jefferson Station, NY 11776
Phone (631) 476-9100

Practitioners & affiliated clinicians

Practitioners 5

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": "1252540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1144553025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110B HALLOCK AVENUE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761210",
            "telephone_number": "631-476-9100",
            "fax_number": "631-476-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110B HALLOCK AVE",
            "city": "PORT JEFFERSON STA",
            "state": "NY",
            "postal_code": "117761210",
            "telephone_number": "631-476-9100",
            "fax_number": "631-476-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR INTERVENTIONAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-10",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "POLLINA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-476-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "193100",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "221708",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "099574",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "186340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Sta, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.