Organization Active NPI

USA Vascular Centers of Miami PLLC

  • Vascular Surgery Physician
  • Hallandale Beach, FL
National Provider Identifier
1861884595
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
USA VASCULAR CENTERS OF MIAMI PLLC
Practice address
1711 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4621
Phone
(954) 688-3928
Fax
(224) 246-8042
NPI assigned
Mar 4, 2015
Last updated
Jan 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Authorized official

Name
Yan Katsnelson, MDNPI 1285672840
Title
Director
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
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X

Addresses

Primary practice location

1711 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4621

Mailing address

4141 Dundee Rd
Northbrook, IL 60062-2129
Phone (847) 257-1244

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180820003649 FL Part B Supplier - Clinic/Group Practice 1557610862 Receives reassigned benefits from 22 practitioners
Practice locations: Hallandale Beach, FL; Miami, FL; Port St Lucie, FL; Sarasota, FL; Tamarac, FL; West Palm Beach, FL

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
10D2161713USA Vascular Centers of Miami PLLC1711 E Hallandale Beach Blvd, Hallandale, FL 33009Certificate of waiverFeb 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
USA Vascular Centers of Miami PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1711 E Hallandale Beach Blvd
Ste A
Hallandale Beach, FL 33009
Phone (954) 688-3968

2250 S Dixie Hwy
Ste 1
Miami, FL 33133
Phone (305) 856-5170

1908 SE Port St Lucie Blvd
Ste A
Port St Lucie, FL 34952

2400 Fruitville Rd
Ste A
Sarasota, FL 34237

5409 N State Road 7
Ste A
Tamarac, FL 33319
Phone (754) 357-0369

4601 N Congress Ave
Ste 101A
West Palm Beach, FL 33407

4141 Dundee Rd
Northbrook, IL 60062
Phone (224) 292-5411

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547683200000",
    "number": "1861884595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 DUNDEE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622129",
            "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": "1711 E HALLANDALE BEACH BLVD",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094621",
            "telephone_number": "954-688-3928",
            "fax_number": "224-246-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA VASCULAR CENTERS OF MIAMI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-04",
        "last_updated": "2019-01-17",
        "status": "A",
        "authorized_official_last_name": "KATSNELSON",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "847-257-1244",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.