Individual provider Active NPI

Larry Horesh, M.D.

  • Vascular & Interventional Radiology Physician
  • Savannah, GA
National Provider Identifier
1154398709
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
057481 Issued in GA
Practice address
4750 Waters Ave
Suite 500
Savannah, GA 31404-6200
Phone
(912) 352-8346
Fax
(912) 355-1414
NPI assigned
Mar 2, 2006
Last updated
Jan 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 057481 GA
Vascular & Interventional Radiology Physician 2085R0204X 057481 GA Primary

Addresses

Primary practice location

4750 Waters Ave
Suite 500
Savannah, GA 31404-6200

Mailing address

PO Box 116336
Atlanta, GA 30368-6336
Phone (912) 352-8346

Other practice location 1

455 S Main St Ste 205
Hinesville, GA 31313-4354
Phone (912) 629-7814

Other identifiers 5

IdentifierTypeStateIssuer
G57481MedicaidSC
308543732DMedicaidGA
3852310MedicaidTN
7124808OtherGAAETNA PPO PROVIDER ID
308543732AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060323000522 GA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 3870489727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Yale University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Savannah Vascular Institute, LLCGroup PAC ID 2769542075, 20 clinicians

Practice addresses (Care Compare)

455 S Main St
Suite 205
Hinesville, GA 31313-4354
Phone (912) 352-8346

7208 Hodgson Memorial Dr
Suite a
Savannah, GA 31406-2512
Phone (912) 629-7800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.11 of 100Reported as group
Quality
51.32
Promoting interoperability
98
Improvement activities
40
Cost
79.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal12
Leg revascularization (restoring blood flow)57
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Savannah Vascular Institute, LLC Vascular & Interventional Radiology CurrentSince Oct 21, 2008 Accepting new patients
Atlantic Radiology Associates, LLC Diagnostic Radiology Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Jackson Madison County General Hospital Past Accepting new patients
Bolivar General Hospital, Inc. Past Accepting new patients
Jackson Radiology Associates PA Diagnostic Radiology Past Accepting new patients

Locations

455 S Main St
Ste 205
Hinesville, GA 31313
Phone (912) 348-9495

166 Memorial Dr
Jesup, GA 31545
Phone (912) 427-2111

4750 Waters Ave
Ste 500
Savannah, GA 31404
Phone (912) 350-5961

7208 Hodgson Memorial Dr
Ste A
Savannah, GA 31406
Phone (912) 351-4555

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: larry.horesh.p1@direct.savannahvascular.nextgenshare.com
  • Direct secure messaging: larry.horesh.p2@direct.savannahvascular.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1154398709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116336",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303686336",
            "telephone_number": "912-352-8346",
            "fax_number": "912-352-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE",
            "address_2": "SUITE 500",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046200",
            "telephone_number": "912-352-8346",
            "fax_number": "912-355-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 S Main St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Hinesville",
            "state": "GA",
            "postal_code": "313134354",
            "country_code": "US",
            "telephone_number": "912-629-7814",
            "fax_number": "912-355-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORESH",
        "first_name": "LARRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "057481",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "057481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G57481",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308543732D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3852310",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO PROVIDER ID",
            "identifier": "7124808",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308543732A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.