Organization Active NPI

USA Vein Clinics of Kent, PLLC

  • Vascular Surgery Physician
  • Kent, WA
National Provider Identifier
1770971871
Registry record updated Dec 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
USA VEIN CLINICS OF KENT, PLLC
Practice address
23914 100TH Ave SE
Kent, WA 98031-4294
Phone
(206) 508-8768
Fax
(224) 246-8042
NPI assigned
Dec 26, 2014
Last updated
Dec 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2014

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

Authorized official

Name
Yan Katsnelson, MDNPI 1285672840
Title
Owner
Phone
(847) 257-1244

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
Internal Medicine Physician 207R00000X
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

23914 100TH Ave SE
Kent, WA 98031-4294

Mailing address

PO Box 1602
Northbrook, IL 60065-1602
Phone (847) 257-1244

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150324002138 WA Part B Supplier - Clinic/Group Practice 9335466762 Receives reassigned benefits from 4 practitioners
Practice locations: Kent, WA

National Provider Directory

National Provider Directory

Locations

23914 100th Ave SE
Kent, WA 98031
Phone (205) 508-8768

26124 Pacific Hwy S
#B
Kent, WA 98032
Phone (205) 508-8768

26212 Pacific Hwy S
Kent, WA 98032
Phone (206) 508-8768

Practitioners & affiliated clinicians

Practitioners 4

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": "1419552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419552000000",
    "number": "1770971871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1602",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600651602",
            "telephone_number": "847-257-1244",
            "fax_number": "224-246-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23914 100TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980314294",
            "telephone_number": "206-508-8768",
            "fax_number": "224-246-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA VEIN CLINICS OF KENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-26",
        "last_updated": "2014-12-26",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-257-1244",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2014; 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.