Northeast Philadelphia Vascular Surgeons PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

NORTHEAST PHILADELPHIA VASCULAR SURGEONS PC

Practice address

2000 Grant Ave
Suite 201
Philadelphia, PA 19115-4378

Phone

(215) 969-3944

Fax

(215) 969-3886

NPI assigned

Jul 5, 2006

Last updated

Nov 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chittur R Mohan, M.D.NPI 1477588259

Title

President

Phone

(215) 969-3944

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

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.

• Chittur R Mohan, M.D.

  • Vascular Surgery Physician
  • Philadelphia, PA
  • NPI 1477588259
  Authorized official Same address or phone

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1881625200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GRANT AVE",
            "address_2": "SUITE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154378",
            "telephone_number": "215-969-3944",
            "fax_number": "215-969-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GRANT AVE",
            "address_2": "SUITE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154378",
            "telephone_number": "215-969-3944",
            "fax_number": "215-969-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PHILADELPHIA VASCULAR SURGEONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "MOHAN",
        "authorized_official_first_name": "CHITTUR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-969-3944",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011942860002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0595939",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0000569420",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHPE",
            "identifier": "0748057000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Vascular Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.