Nepa Vascular LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

NEPA VASCULAR LLC

Practice address

1918 W Front St
Berwick, PA 18603-4230

Phone

(570) 616-8589

Fax

(570) 616-8590

NPI assigned

Feb 19, 2024

Organization subpart

No

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

Authorized official

Name

John Guerriero III, DONPI 1952525958

Title

Owner Provider

Phone

(570) 616-8589

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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.

• John Anthony Guerriero III, D.O.

  • Vascular Surgery Physician
  • Berwick, PA
  • NPI 1952525958

  PA, Vascular Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Michael Levandowski, CRNP

  • Family Nurse Practitioner
  • Wilkes Barre, PA
  • NPI 1023275955

  Nurse Practitioner, PA

  Medicare reassignment Care Compare group NPD
• Stephanie Lilly, CRNP

  • Adult Health Nurse Practitioner
  • Bear Creek Township, PA
  • NPI 1285101592

  PA

  Medicare reassignment Care Compare group NPD
• Anton Lyubomirov Georgiev, DO

  • Surgery Physician
  • Berwick, PA
  • NPI 1841412145

  PA

  Medicare reassignment NPD
• Christopher Allan Borgna, PA-C

  • Physician Assistant
  • Scranton, PA
  • NPI 1497039457

  PA

  Medicare reassignment

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1679338685",
    "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": "570-616-8589",
            "fax_number": "570-616-8590"
        },
        {
            "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": "570-616-8589",
            "fax_number": "570-616-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPA VASCULAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "GUERRIERO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "570-616-8589",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Marie Motovidlak, PA-C
• Amanda S Mullins, PA-C
• Victor Muneshwar, MD
• Autumn Lee Muntz, RPH
• Nepa Vascular Institute LLC
• Mehdi Nikparvarfard
• Northeast Counseling Services
• Kristin Onisick, MSN RN
• Stacey Osenbruck
• Osman Medical Care, PLLC

• All providers in Berwick, PA
• Vascular Surgery Physician in Pennsylvania

• 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.