NPIMap

Organization Active NPI

Metropolitan Vascular Institute LLC

  • Ambulatory Surgical Clinic/Center
  • Waldorf, MD
National Provider Identifier
1871187245
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
METROPOLITAN VASCULAR INSTITUTE LLC
Practice address
3015 Technology Place Suite 110
Waldorf, MD 20601
Phone
(301) 374-8540
Fax
(301) 374-8541
NPI assigned
Feb 25, 2021
Last updated
Feb 25, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
METROPOLITAN VASCULAR INSTITUTE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Authorized official

Name
Anish P Shah, MDNPI 1699790436
Title
Ceo
Phone
(703) 763-5224

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary
Nephrology Physician 207RN0300X
Vascular & Interventional Radiology Physician 2085R0204X
Vascular Surgery Physician 2086S0129X

Addresses

Primary practice location

3015 Technology Place Suite 110
Waldorf, MD 20601

Mailing address

14085 Crown CT
Woodbridge, VA 22193-1458
Phone (703) 763-5224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210513001764 MD Part B Supplier - Ambulatory Surgical Center 6709139363 Receives reassigned benefits from 4 practitioners
Practice locations: Waldorf, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Metropolitan Vascular Institute LLCCCN 21C0001643
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Metropolitan Vascular Institute LLC3 organizations share this tax ID, including this one
Part of
Metropolitan Vascular Institute LLC

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1871187245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14085 CROWN CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931458",
            "telephone_number": "703-763-5224",
            "fax_number": "703-763-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 TECHNOLOGY PLACE SUITE 110",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20601",
            "telephone_number": "301-374-8540",
            "fax_number": "301-374-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN VASCULAR INSTITUTE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METROPOLITAN VASCULAR INSTITUTE LLC",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ANISH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-763-5224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.