NPIMap

Organization Active NPI

Pennsylvania Vascular Associates, P.C.

Doing business as PA Vascular Assoc.

  • Vascular Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1578625349
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
PENNSYLVANIA VASCULAR ASSOCIATES, P.C.
Doing business as
PA Vascular Assoc.
Practice address
700 Spruce Street
Ste 101
Philadelphia, PA 19106-0423
Phone
(215) 829-5000
Fax
(215) 627-0578
NPI assigned
Dec 15, 2006
Last updated
Jan 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Authorized official

Name
Ms. Bridget Anne Walsh
Title
Practice Manager
Phone
(215) 829-5093

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X PA Primary

Addresses

Primary practice location

700 Spruce Street
Ste 101
Philadelphia, PA 19106-0423

Mailing address

700 Spruce Street
Ste 101
Philadelphia, PA 19106-0423
Phone (215) 829-5000

Other identifiers 2

IdentifierTypeStateIssuer
0016875000001MedicaidPA
CN5867OtherPARAILROAD MEDICARE

Other names 1

  • PA Vascular Assoc. Doing business as

National Provider Directory

National Provider Directory

Locations

700 Spruce St
Ste 101
Philadelphia, PA 19106
Phone (215) 829-5000

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1578625349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SPRUCE STREET",
            "address_2": "STE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191060423",
            "telephone_number": "215-829-5000",
            "fax_number": "215-627-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SPRUCE STREET",
            "address_2": "STE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191060423",
            "telephone_number": "215-829-5000",
            "fax_number": "215-627-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA VASCULAR ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "215-829-5093",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016875000001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN5867",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PA Vascular Assoc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 10, 2013; 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.