Organization Active NPI

Avance Vein Care LLC

  • Vascular Surgery Physician
  • Sparta, NJ
National Provider Identifier
1376415133
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
AVANCE VEIN CARE LLC
Practice address
1 Wilson Dr
Sparta, NJ 07871-4416
Phone
(417) 849-8450
NPI assigned
Sep 22, 2025
Last updated
Jul 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Authorized official

Name
Satish Tadepalli, MDNPI 1972066652
Title
Medical Provider
Phone
(417) 849-8450

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1 Wilson Dr
Sparta, NJ 07871-4416

Mailing address

1 Wilson Dr
Sparta, NJ 07871-4416
Phone (929) 260-0026

National Provider Directory

National Provider Directory

Locations

1 Wilson Dr
Sparta, NJ 07871
Phone (929) 260-0026

1 Wilson Dr
Ste 2A
Sparta, NJ 07871

Practitioners & affiliated clinicians

Practitioners 1

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": "1758499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1376415133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WILSON DR",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078714416",
            "telephone_number": "929-260-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WILSON DR",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078714416",
            "telephone_number": "417-849-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANCE VEIN CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-22",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "TADEPALLI",
        "authorized_official_first_name": "SATISH",
        "authorized_official_title_or_position": "MEDICAL PROVIDER",
        "authorized_official_telephone_number": "417-849-8450",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "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": []
}

Other providers in Sparta, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.