Organization Active NPI

Comprehensive Vein Care Inc

Doing business as Personal Care Family Practice

  • Vascular Surgery Physician
  • Berwick, PA
National Provider Identifier
1508583022
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
COMPREHENSIVE VEIN CARE INC
Doing business as
Personal Care Family Practice
Practice address
1918 W Front St
Berwick, PA 18603-4230
Phone
(570) 616-8594
NPI assigned
Oct 25, 2022
Last updated
Sep 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Verona Roberts, NPNPI 1477986719
Title
Owner
Phone
(570) 616-8594

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Nurse Practitioner 363LF0000X
Family Medicine Physician 207Q00000X
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

1918 W Front St
Berwick, PA 18603-4230

Mailing address

1918 W Front St
Berwick, PA 18603-4230
Phone (570) 616-8594

Other names 1

  • Personal Care Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221107003438 PA Part B Supplier - Clinic/Group Practice 0840667689 Receives reassigned benefits from 2 practitioners
Practice locations: Avoca, PA; Berwick, PA; Lewisburg, PA; McAdoo, PA; Milton, PA

National Provider Directory

National Provider Directory

Locations

400 Gleason Dr
Avoca, PA 18641
Phone (570) 616-8594

2050 W Front St
Berwick, PA 18603
Phone (570) 616-8594

327 Farley Cir
Lewisburg, PA 17837
Phone (570) 616-8594

20 N Kennedy Dr
McAdoo, PA 18237
Phone (570) 616-8594

560 Broadway St
Milton, PA 17847
Phone (570) 616-8594

Practitioners & affiliated clinicians

Practitioners 2

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": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1508583022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 W FRONT ST",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186034230",
            "telephone_number": "570-616-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 W FRONT ST",
            "city": "BERWICK",
            "state": "PA",
            "postal_code": "186034230",
            "telephone_number": "570-616-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE VEIN CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "VERONA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-616-8594",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "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": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Personal Care Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berwick, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.