NPIMap

Organization Active NPI

USA Vascular Center of Decatur LLC

  • Vascular Surgery Physician
  • Decatur, GA
National Provider Identifier
1487133278
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
USA VASCULAR CENTER OF DECATUR LLC
Practice address
495 Winn Way Ste 230
Decatur, GA 30030-1736
Phone
(847) 593-8460
NPI assigned
Aug 13, 2018
Last updated
Oct 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Yan Katsnelson, M.D.NPI 1285672840
Title
Ceo/President
Phone
(224) 318-0118

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 10

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Cardiovascular Disease Physician 207RC0000X
Interventional Cardiology Physician 207RI0011X
Vascular & Interventional Radiology Physician 2085R0204X
Surgery Physician 208600000X
Surgical Critical Care Physician 2086S0102X
Vascular Surgery Physician 2086S0129X Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X

Addresses

Primary practice location

495 Winn Way Ste 230
Decatur, GA 30030-1736

Mailing address

PO Box 1602
Northbrook, IL 60065-1602
Phone (847) 593-8460

Other practice location 1

1200 Johnson Ferry Rd Ste T-100A
Marietta, GA 30068-5403
Phone (470) 435-7040

Other practice location 2

1800 Howell Mill Rd NW Ste 130A
Atlanta, GA 30318-0916
Phone (404) 532-1564

Other practice location 3

3875 Austell Rd Ste 201A
Austell, GA 30106-1153
Phone (470) 372-1901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181113000567 GA Part B Supplier - Clinic/Group Practice 1052665957 Receives reassigned benefits from 10 practitioners
Practice locations: Marietta, GA; Austell, GA; Atlanta, GA; Decatur, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2169075USA Vascular Center of Decatur, LLC495 Winn Drive, Suite 230, Decatur, GA 30030Certificate of waiverJul 15, 2027

National Provider Directory

National Provider Directory

Locations

1800 Howell Mill Rd NW
Ste 130
Atlanta, GA 30318
Phone (404) 355-8775

3875 Austell Rd
Ste 201A
Austell, GA 30106
Phone (470) 372-1901

495 Winn Way
Ste 230
Decatur, GA 30030
Phone (470) 237-4232

1200 Johnson Ferry Rd
Ste 1000A
Marietta, GA 30068

1200 Johnson Ferry Rd
Ste T100A
Marietta, GA 30068
Phone (470) 435-7040

Practitioners & affiliated clinicians

Practitioners 11

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": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1487133278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1602",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600651602",
            "telephone_number": "847-593-8460",
            "fax_number": "224-235-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 WINN WAY STE 230",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301736",
            "telephone_number": "847-593-8460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Johnson Ferry Rd Ste T-100A",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300685403",
            "country_code": "US",
            "telephone_number": "470-435-7040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Howell Mill Rd NW Ste 130A",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303180916",
            "country_code": "US",
            "telephone_number": "404-532-1564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3875 Austell Rd Ste 201A",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301061153",
            "country_code": "US",
            "telephone_number": "470-372-1901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "USA VASCULAR CENTER OF DECATUR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-13",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "224-318-0118",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.