USA Vein Clinics of Utah LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

USA VEIN CLINICS OF UTAH LLC

Practice address

6028 S Ridgeline Dr
Ogden, UT 84405-6914

Phone

(385) 432-5838

Fax

(224) 235-4652

NPI assigned

Aug 18, 2020

Last updated

Aug 18, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Flora Katsnelson, M.D.

Title

Owner

Phone

(847) 593-8460

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 7

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.

• Cabot Stratford Murdock, M.D

  • Surgery Physician
  • Riverton, UT
  • NPI 1225024961
  Medicare reassignment Care Compare group NPD
• Wan-Lin Horng, M.D.

  • Surgery Physician
  • Glendale, AZ
  • NPI 1619037405

  UT

  Medicare reassignment Care Compare group NPD
• Gustavo Velasquez, MD

  • Family Medicine Physician
  • South Jordan, UT
  • NPI 1821211988
  Medicare reassignment NPD
• Kitae Kim, MD

  • Surgical Critical Care Physician
  • Las Vegas, NV
  • NPI 1033188289

  UT

  Medicare reassignment NPD
• Ernest Bray, MD

  • General Practice Physician
  • St George, UT
  • NPI 1316641665
  Medicare reassignment
• Jeffrey J Juchau, M.D.

  • Family Medicine Physician
  • Spanish Fork, UT
  • NPI 1225083504
  NPD
• Rex Chang Manayan, M.D.

  • Vascular Surgery Physician
  • Ontario, CA
  • NPI 1649278599
  NPD

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1225640717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 WAINWRIGHT DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621900",
            "telephone_number": "847-593-8460",
            "fax_number": "224-235-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6028 S RIDGELINE DR",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056914",
            "telephone_number": "385-432-5838",
            "fax_number": "224-235-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA VEIN CLINICS OF UTAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "FLORA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-593-8460",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Vascular Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.