NPIMap

Organization Active NPI

Flint Vascular Surgery P.L.L.C.

Doing business as Vascular Institute of Michigan

  • Vascular Surgery Physician
  • Flint, MI
National Provider Identifier
1710374137
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301084542 Issued in MI
Legal business name
FLINT VASCULAR SURGERY P.L.L.C.
Doing business as
Vascular Institute of Michigan
Practice address
1325 S Linden Rd
Flint, MI 48532-3408
Phone
(810) 813-4094
NPI assigned
Apr 23, 2015
Last updated
Apr 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Authorized official

Name
Mr. Amer Iqbal
Title
Business Director
Phone
(810) 813-4094

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 4301099987 MI
Vascular Surgery Physician 2086S0129X 4301084542 MI Primary

Addresses

Primary practice location

1325 S Linden Rd
Flint, MI 48532-3408

Mailing address

PO Box 320755
Flint, MI 48532-0755
Phone (810) 813-4094

Other names 1

  • Vascular Institute of Michigan Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150604001747 MI Part B Supplier - Clinic/Group Practice 8820319684 Receives reassigned benefits from 6 practitioners
Practice locations: Flint, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2097178Vascular Institute of Michigan1325 S Linden Road, Flint, MI 48532Certificate of waiverJul 12, 2027

National Provider Directory

National Provider Directory

Locations

802 W King St
Ste K
Owosso, MI 48867
Phone (517) 484-0004

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1710374137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320755",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485320755",
            "telephone_number": "810-813-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S LINDEN RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323408",
            "telephone_number": "810-813-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLINT VASCULAR SURGERY P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "IQBAL",
        "authorized_official_first_name": "AMER",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "810-813-4094",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301099987",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301084542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vascular Institute of Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.