Premier Vascular Care PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

4301093222 Issued in MI

Legal business name

PREMIER VASCULAR CARE PC

Practice address

1701 South Blvd E Ste B75
Rochester Hills, MI 48307-6122

Phone

(248) 243-3935

Fax

(248) 284-7530

NPI assigned

Mar 7, 2012

Organization subpart

No

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

Authorized official

Name

Ajith Kadakol, MDNPI 1891742128

Title

Physician / Owner

Phone

(586) 573-8030

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ajith K Kadakol, M.D.

  • Vascular Surgery Physician
  • Rochester Hills, MI
  • NPI 1891742128
  Medicare reassignment Authorized official
• Sohini Naik

  • Family Nurse Practitioner
  • Rochester Hills, MI
  • NPI 1457012619
  Medicare reassignment NPD

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1639443773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 LEGACY CT",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233634",
            "telephone_number": "583-573-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E STE B75",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076122",
            "telephone_number": "248-243-3935",
            "fax_number": "248-284-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43211 Dalcoma Dr",
            "address_2": "NORTH WING SUITE B",
            "address_purpose": "LOCATION",
            "city": "Clinton Twp",
            "state": "MI",
            "postal_code": "480386309",
            "country_code": "US",
            "telephone_number": "586-573-8030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "43211 Dalcoma Dr",
            "address_2": "NORTH WING SUITE B",
            "address_purpose": "LOCATION",
            "city": "Clinton Twp",
            "state": "MI",
            "postal_code": "480386309",
            "country_code": "US",
            "telephone_number": "586-573-8030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER VASCULAR CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KADAKOL",
        "authorized_official_first_name": "AJITH",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "586-573-8030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301093222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315045037",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301093222",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDV NPI",
            "identifier": "1891742128",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Prather, D.C.
• Precise Medical Care PLLC
• Premier Foot & Ankle PLLC
• Premier Health Consultants PLLC
• Premier Surgical Specialists, PC
• Prescriptiongiant LLC
• Pressio Medical LLC
• Beverly Susan Price, RD
• Amanda Primozich, PA-C
• Troy Prince, DC

• Vascular Surgery Physician in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Vascular Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.