Organization Active NPI

Vascular Surgery Associate of Suffolk County, PLLC

  • Vascular Surgery Physician
  • Patchogue, NY
National Provider Identifier
1477893113
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR SURGERY ASSOCIATE OF SUFFOLK COUNTY, PLLC
Practice address
33 Medford Ave Ste a
Patchogue, NY 11772-1222
Phone
(631) 569-5410
Fax
(631) 569-5413
NPI assigned
Feb 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Authorized official

Name
Danielle Cowan
Title
Manager
Phone
(631) 569-5410

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

33 Medford Ave Ste a
Patchogue, NY 11772-1222

Mailing address

33 Medford Ave Ste a
Patchogue, NY 11772-1222
Phone (631) 569-5410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150219001244 NY Part B Supplier - Clinic/Group Practice 2466777230 Receives reassigned benefits from 3 practitioners
Practice locations: Patchogue, NY

National Provider Directory

National Provider Directory

Locations

74 Southaven Ave
Ste E
Medford, NY 11763
Phone (516) 654-2386

33 Medford Ave
Ste A
Patchogue, NY 11772
Phone (631) 569-5410

Practitioners & affiliated clinicians

Practitioners 4

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": "1361059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1477893113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MEDFORD AVE STE A",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721222",
            "telephone_number": "631-569-5410",
            "fax_number": "631-569-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 MEDFORD AVE STE A",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721222",
            "telephone_number": "631-569-5410",
            "fax_number": "631-569-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR SURGERY ASSOCIATE OF SUFFOLK COUNTY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-17",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "631-569-5410"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "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 Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; 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.