A&a Vascular, PLLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

A&A VASCULAR, PLLC

Doing business as

Lake State Vein and Vascular

Practice address

37504 7 Mile Rd
Livonia, MI 48152-1004

Phone

(734) 744-4100

NPI assigned

Apr 5, 2023

Last updated

Jul 11, 2023By 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

Robin Fox

Title

Credentialing Manager

Phone

(248) 568-8280

Specialties & licenses 2

Addresses

Other names 1

• Lake State Vein and Vascular Doing business as

Locations

Practitioners 2

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.

• Dianna Grace Ehlert, MSN, RN, AGACNP-BC

  • Adult Health Nurse Practitioner
  • Detroit, MI
  • NPI 1336695923
  NPD
• Ali Harb, MD

  • Vascular & Interventional Radiology Physician
  • Detroit, MI
  • NPI 1588787808
  NPD

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1285339408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37504 7 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521004",
            "telephone_number": "734-744-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37504 7 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521004",
            "telephone_number": "734-744-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A&A VASCULAR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "248-568-8280"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake State Vein and Vascular",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vascular Surgery Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Vascular Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.