Peripheral Vascular Associates, P.a.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

PERIPHERAL VASCULAR ASSOCIATES, P.A.

Practice address

610 North Main Avenue
2ND Floor
San Antonio, TX 78205-1204

Phone

(210) 237-4492

Fax

(210) 828-0590

NPI assigned

May 26, 2006

Last updated

Jul 21, 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

Ms. Phyllis B. Davenport

Title

Administrator

Phone

(210) 237-4492

Specialties & licenses 11

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Juan Diego Martinez, MD

  • Cardiovascular Disease Physician
  • San Antonio, TX
  • NPI 1245434810

  Interventional Cardiology

  Medicare reassignment NPD
• Heather Guadalupe Aguirre, D.O.

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • San Antonio, TX
  • NPI 1346687787
  NPD
• Jeffrey Robert Forbes, L.P.

  • Prosthetist
  • San Antonio, TX
  • NPI 1700170578
  NPD
• William Stanley Vydrzal, C.P.

  • Prosthetist
  • San Antonio, TX
  • NPI 1669721338
  NPD
• Jacqueline M Alexander, LVN

  • Licensed Vocational Nurse
  • San Antonio, TX
  • NPI 1801103510
  NPD (past)
• Nancy Leigh Allyn, RN

  • Registered Nurse
  • San Antonio, TX
  • NPI 1477869287
  NPD (past)
• Ronald L. Blumoff, M.D.

  • Vascular Surgery Physician
  • San Antonio, TX
  • NPI 1861498982
  NPD (past)
• Katherine E Britt

  • Registered Nurse
  • San Antonio, TX
  • NPI 1124334925
  NPD (past)
• Karen Burton, LVN

  • Licensed Vocational Nurse
  • San Antonio, TX
  • NPI 1174839963
  NPD (past)
• Cindy Cruz, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
  • NPI 1982910709
  NPD (past)
• Erin Faz, RN

  • Registered Nurse
  • San Antonio, TX
  • NPI 1134436389
  NPD (past)
• Lynda Darlene Garcia, LVN

  • Licensed Vocational Nurse
  • San Antonio, TX
  • NPI 1811261274
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1396791570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 NORTH MAIN, SECOND FLOOR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051204",
            "telephone_number": "210-237-4492",
            "fax_number": "210-828-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 NORTH MAIN AVENUE",
            "address_2": "2ND FLOOR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051204",
            "telephone_number": "210-237-4492",
            "fax_number": "210-828-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIPHERAL VASCULAR ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "210-237-4492",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pablo Ezequiel Pergola, MD
• Kay Pergrem
• Katarina Morgan Perguson
• Perin Gomer Suthakar MD
• Perinatal & Infertility Specialists PA (Perinatal Associates of San Antonio PA)
• Cindy Carol Perkins-Wereley, L.C.S.W.
• Adelie Tristan Perkins, MD
• Avis Perkins, RN
• Cory Perkins, IONM
• Derek Perkins, M.S, CCC-SLP

• Vascular Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Vascular Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.