NPIMap

Organization Active NPI

Mount Sinai Vascular Institute, LLC

  • Vascular & Interventional Radiology Physician
  • Miami Beach, FL
National Provider Identifier
1871160879
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
MOUNT SINAI VASCULAR INSTITUTE, LLC
Practice address
4300 Alton Rd Ste 2071
Miami Beach, FL 33140-2948
Phone
(305) 674-2906
Fax
(305) 674-3927
NPI assigned
Jun 8, 2021
Last updated
Jun 8, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNT SINAI MEDICAL CENTER OF FLORIDA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Mr. Wayne Chutkan
Title
VP of Finance
Phone
(305) 674-2662

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X Primary
Vascular Surgery Physician 2086S0129X

Addresses

Primary practice location

4300 Alton Rd Ste 2071
Miami Beach, FL 33140-2948

Mailing address

PO Box 527824
Miami, FL 33152-7824
Phone (305) 535-3349

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210803001926 FL Part B Supplier - Clinic/Group Practice 2567866296 Receives reassigned benefits from 15 practitioners
Practice locations: North Miami Beach, FL; Miami Beach, FL; Marathon, FL; Hialeah, FL; Key West, FL; Aventura, FL; Coral Gables, FL

National Provider Directory

National Provider Directory
Part of
Mount Sinai Hospital

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6050 W 20th Ave
#3
Hialeah, FL 33016
Phone (305) 674-2906

3401 Northside Dr
Key West, FL 33040
Phone (305) 292-9688

4300 Alton Rd
#2071
Miami Beach, FL 33140
Phone (305) 674-2071

4300 Alton Rd
Bldg Fifth
Miami Beach, FL 33140
Phone (305) 674-2906

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1871160879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 527824",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331527824",
            "telephone_number": "305-535-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 ALTON RD STE 2071",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402948",
            "telephone_number": "305-674-2906",
            "fax_number": "305-674-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT SINAI VASCULAR INSTITUTE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "CHUTKAN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "305-674-2662",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.