NPIMap

Organization Active NPI

Montgomery Vascular Surgery, P.C.

  • Specialist
  • Montgomery, AL
National Provider Identifier
1225059165
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
378 Issued in AL
Legal business name
MONTGOMERY VASCULAR SURGERY, P.C.
Practice address
2055 E South Blvd Ste 503
Montgomery, AL 36116-2004
Phone
(334) 284-6500
Fax
(334) 284-6202
NPI assigned
Jul 23, 2006
Last updated
May 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Authorized official

Name
Dr. Robert E Engles, MDNPI 1396766242
Title
President
Phone
(334) 284-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 378 AL Primary

Addresses

Primary practice location

2055 E South Blvd Ste 503
Montgomery, AL 36116-2004

Mailing address

2055 E South Blvd Ste 503
Montgomery, AL 36116-2004
Phone (334) 284-6500

Other practice location 1

277 Huntress St Ste 201
Wetumpka, AL 36092-3342
Phone (334) 284-6500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051123000568 AL Part B Supplier - Clinic/Group Practice 0840210530 Receives reassigned benefits from 9 practitioners
Practice locations: Montgomery, AL; Selma, AL; Wetumpka, AL

National Provider Directory

National Provider Directory

Locations

2055 E South Blvd
Ste 503
Montgomery, AL 36116
Phone (205) 284-6500

2055 E South Blvd
Ste 601
Montgomery, AL 36116
Phone (334) 281-9000

2055 E South Blvd
Ste 710
Montgomery, AL 36116
Phone (334) 284-6500

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716768000000",
    "number": "1225059165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD STE 503",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162004",
            "telephone_number": "334-284-6500",
            "fax_number": "334-284-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD STE 503",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162004",
            "telephone_number": "334-284-6500",
            "fax_number": "334-284-6202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 Huntress St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Wetumpka",
            "state": "AL",
            "postal_code": "360923342",
            "country_code": "US",
            "telephone_number": "334-284-6500",
            "fax_number": "334-284-6202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MONTGOMERY VASCULAR SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A",
        "authorized_official_last_name": "ENGLES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-284-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.