NPIMap

Organization Active NPI

USA Vascular Center of Chantilly LLC

  • Vascular Surgery Physician
  • Falls Church, VA
National Provider Identifier
1255901450
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
USA VASCULAR CENTER OF CHANTILLY LLC
Practice address
5860 Columbia Pike Ste 105a
Falls Church, VA 22041-2047
Phone
(847) 593-8460
NPI assigned
Jun 29, 2021
Last updated
Apr 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Yan Katsnelson, MDNPI 1285672840
Title
Owner
Phone
(847) 593-8460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

5860 Columbia Pike Ste 105a
Falls Church, VA 22041-2047

Mailing address

PO Box 971
Northbrook, IL 60065-0971
Phone (847) 593-8460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211216001637 DC Part B Supplier - Clinic/Group Practice 6002207503 Receives reassigned benefits from 4 practitioners
Practice locations: Vienna, VA

National Provider Directory

National Provider Directory

Locations

1500 Cornerside Blvd
Ste 300A
Vienna, VA 22182

Practitioners & affiliated clinicians

Practitioners 5

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": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1255901450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 971",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650971",
            "telephone_number": "847-593-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 COLUMBIA PIKE STE 105A",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220412047",
            "telephone_number": "847-593-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA VASCULAR CENTER OF CHANTILLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-593-8460",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.