NPIMap

Organization Active NPI

Center for Vein Restoration MD LLC

  • Vascular Surgery Physician
  • Bel Air, MD
National Provider Identifier
1174345508
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
620 W Macphail Rd Ste 104
Bel Air, MD 21014-4474
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 Physician 2086S0129X NU Primary

Addresses

Primary practice location

620 W Macphail Rd Ste 104
Bel Air, MD 21014-4474

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 MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251212002180 MD DME Supplier - Physician - Thoracic Surgery 8729022736 Practice locations: Bel Air, MD

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": "1174345508",
    "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": "815-254-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W MACPHAIL RD STE 104",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144474",
            "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": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

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.