Advanced Vein Center, Inc.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

G47710 Issued in CA

Legal business name

ADVANCED VEIN CENTER, INC.

Doing business as

Advanced Vein Center

Practice address

431 S Batavia St Ste 101
Orange, CA 92868-3937

Phone

(714) 955-5960

Fax

(714) 955-5965

NPI assigned

Dec 7, 2007

Last updated

Aug 4, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bruce R Hoyle, M.D.NPI 1225184518

Title

President

Phone

(714) 955-5960

Specialties & licenses 1

Addresses

Other names 1

• Advanced Vein Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 5

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.

• Matthew Jay Wise, M.D.

  • Phlebology Physician
  • Orange, CA
  • NPI 1235107038
  Medicare reassignment Care Compare group NPD
• Mark Macumber, MD

  • Phlebology Physician
  • Meridian, ID
  • NPI 1598805830

  CA

  Medicare reassignment Care Compare group NPD
• Layla Shirkhorshidi, PA-C

  • Physician Assistant
  • Orange, CA
  • NPI 1114653144
  Medicare reassignment Care Compare group
• Bruce R Hoyle, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Orange, CA
  • NPI 1225184518
  Authorized official Same address or phone
• Mahesh G. Shah, M.D.

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1497783591
  NPD (past)

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1659554095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 S BATAVIA ST STE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683937",
            "telephone_number": "714-955-5960",
            "fax_number": "714-955-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 S BATAVIA ST STE 101",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683937",
            "telephone_number": "714-955-5960",
            "fax_number": "714-955-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VEIN CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "HOYLE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-955-5960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "G47710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Vein Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Vein Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Preferred Provider Organization in Orange, CA
• Providers in Orange, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.