NPIMap

Organization Active NPI

Peripheral Vascular Institute, Inc. a Podiatry Corp

  • Vascular & Interventional Radiology Physician
  • Oxnard, CA
National Provider Identifier
1336708494
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
PERIPHERAL VASCULAR INSTITUTE, INC. A PODIATRY CORP
Practice address
2100 Solar Dr Ste 103
Oxnard, CA 93036-0649
Phone
(805) 293-6436
Fax
(877) 544-7992
NPI assigned
Jun 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Authorized official

Name
Vladimir Zeetser, DPMNPI 1366449985
Title
Authorized Official
Phone
(805) 293-6436

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X Primary
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

2100 Solar Dr Ste 103
Oxnard, CA 93036-0649

Mailing address

2100 Solar Dr Ste 103
Oxnard, CA 93036-0649

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190624002592 CA Part B Supplier - Clinic/Group Practice 2062746175 Receives reassigned benefits from 7 practitioners
Practice locations: Oxnard, CA

National Provider Directory

National Provider Directory

Locations

2100 Solar Dr
Ste 103
Oxnard, CA 93036
Phone (805) 293-6436

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561334400000",
    "number": "1336708494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SOLAR DR STE 103",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SOLAR DR STE 103",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930360649",
            "telephone_number": "805-293-6436",
            "fax_number": "877-544-7992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIPHERAL VASCULAR INSTITUTE, INC. A PODIATRY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-24",
        "status": "A",
        "authorized_official_last_name": "ZEETSER",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "805-293-6436",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.