NPIMap

Organization Active NPI

Maryland and Virginia Phlebology PC

  • Surgery Physician
  • Pikesville, MD
National Provider Identifier
1679375216
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MARYLAND AND VIRGINIA PHLEBOLOGY PC
Practice address
1809 Reisterstown Rd Ste 146
Pikesville, MD 21208-6329
Phone
(410) 580-0057
NPI assigned
Mar 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Authorized official

Name
Yan Katsnelson, MD
Title
Owner
Phone
(847) 593-8460

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202K00000X
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X

Addresses

Primary practice location

1809 Reisterstown Rd Ste 146
Pikesville, MD 21208-6329

Mailing address

304 Wainwright Dr Ste 120
Northbrook, IL 60062-1919
Phone (847) 257-1244

National Provider Directory

National Provider Directory
Tax ID family
MD VA Phlebology PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1679375216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 WAINWRIGHT DR STE 120",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621919",
            "telephone_number": "847-257-1244",
            "fax_number": "224-235-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 REISTERSTOWN RD STE 146",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086329",
            "telephone_number": "410-580-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND AND VIRGINIA PHLEBOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-593-8460",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.