NPIMap

Organization Active NPI

Peripheral Vascular Institute of Philadelphia LLC

  • Vascular-Interventional Technology Radiologic Technologist
  • Philadelphia, PA
National Provider Identifier
1396074480
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular-Interventional Technology Radiologic TechnologistTaxonomy code 2471V0106X
Legal business name
PERIPHERAL VASCULAR INSTITUTE OF PHILADELPHIA LLC
Practice address
4220 Market St
2ND Floor
Philadelphia, PA 19104-3007
Phone
(215) 382-3680
Fax
(215) 382-3683
NPI assigned
Dec 18, 2009
Last updated
Mar 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Authorized official

Name
James McGuckin, MD
Title
Ceo
Phone
(215) 382-3680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular-Interventional Technology Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471V0106X Primary

Addresses

Primary practice location

4220 Market St
2ND Floor
Philadelphia, PA 19104-3007

Mailing address

4220 Market St FL 2
Philadelphia, PA 19104-3007
Phone (215) 382-3680

National Provider Directory

National Provider Directory

Locations

70 Cornwell Dr
Bridgeton, NJ 08302
Phone (856) 455-6770

118 Fries Mill Rd
#N2
Turnersville, NJ 08012
Phone (215) 240-6007

13 Market Pl
Ste 60
New Hope, PA 18938
Phone (215) 862-2084

1701 W Ritner St
Philadelphia, PA 19145
Phone (215) 336-2145

2516 Germantown Ave
Philadelphia, PA 19133
Phone (215) 225-7929

4220 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 240-6007

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1396074480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 MARKET ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043007",
            "telephone_number": "215-382-3680",
            "fax_number": "215-382-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 MARKET ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043007",
            "telephone_number": "215-382-3680",
            "fax_number": "215-382-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIPHERAL VASCULAR INSTITUTE OF PHILADELPHIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-18",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "MCGUCKIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-382-3680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2471V0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular-Interventional Technology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.