Organization Active NPI

USA Vascular Center of Morgantown PLLC

  • Vascular Surgery Physician
  • Morgantown, WV
National Provider Identifier
1235754581
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
USA VASCULAR CENTER OF MORGANTOWN PLLC
Practice address
1010 Suncrest Towne Centre
Morgantown, WV 26505
Phone
(847) 593-8460
Fax
(224) 235-4652
NPI assigned
Jun 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Authorized official

Name
Ami Almeda
Title
Credentialing Manager
Phone
(224) 318-0118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1010 Suncrest Towne Centre
Morgantown, WV 26505

Mailing address

PO Box 791
Northbrook, IL 60065-0791
Phone (847) 593-8460

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2201156USA Vascular Center of Morgantown PLLC1010 Suncrest Towne Centre, Morgantown, WV 26505Certificate of waiverNov 18, 2026

National Provider Directory

National Provider Directory

Locations

1010 Suncrest Towne Centre
Ste a
Morgantown, WV 26505
Phone (304) 413-1166

1010 Suncrest Towne Centre Dr
Ste a
Morgantown, WV 26505
Phone (304) 413-1166

NPI Registry JSON

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1235754581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650791",
            "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": "1010 SUNCREST TOWNE CENTRE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26505",
            "telephone_number": "847-593-8460",
            "fax_number": "224-235-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA VASCULAR CENTER OF MORGANTOWN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "ALMEDA",
        "authorized_official_first_name": "AMI",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "224-318-0118"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.