NPIMap

Organization Active NPI

Vascular Surgery Assoc PC

Doing business as Michigan Vascular Center

  • Vascular Surgery Physician
  • Flint, MI
National Provider Identifier
1710959150
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR SURGERY ASSOC PC
Doing business as
Michigan Vascular Center
Practice address
5020 W Bristol Rd
Flint, MI 48507-2919
Phone
(810) 732-1620
Fax
(810) 732-8559
NPI assigned
Feb 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Mr. Joseph Jacot, MBANPI 1982758090
Title
Business Administrator
Phone
(810) 732-1620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

5020 W Bristol Rd
Flint, MI 48507-2919

Mailing address

5020 W Bristol Rd
Flint, MI 48507-2919
Phone (810) 732-1620

Other identifiers 1

IdentifierTypeStateIssuer
020B560600OtherMIBC/BS OF MICHIGAN

Other names 1

  • Michigan Vascular Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040526000486 MI Part B Supplier - Clinic/Group Practice 2567443559 Receives reassigned benefits from 17 practitioners
Practice locations: Flint, MI; Saginaw, MI; Lapeer, MI
O20120419000196 MI DME Supplier - Physician - Unknown Physician SpecialtyDME Supplier - Prosthetic Personnel 2567443559 Practice locations: Flint, MI

National Provider Directory

National Provider Directory

Locations

5202 Miller Rd
Ste B
Flint, MI 48507
Phone (810) 720-1600

4700 McLeod Dr E
Ste A
Saginaw, MI 48604
Phone (989) 791-4652

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1710959150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072919",
            "telephone_number": "810-732-1620",
            "fax_number": "810-732-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072919",
            "telephone_number": "810-732-1620",
            "fax_number": "810-732-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR SURGERY ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "JACOT",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "810-732-1620",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MICHIGAN",
            "identifier": "020B560600",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michigan Vascular Center",
            "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 Dec 20, 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.