NPIMap

Organization Active NPI

Center for Vein Restoration Ga Corp

  • Vascular Surgery Physician
  • Atlanta, GA
National Provider Identifier
1902423387
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
CENTER FOR VEIN RESTORATION GA CORP
Practice address
1100 Johnson Fy Rd NE Ste 165
Atlanta, GA 30342-1795
Phone
(855) 830-8346
Fax
(240) 473-4321
NPI assigned
Jul 1, 2020
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Dr. Sanjiv Lakhanpal, MDNPI 1124074083
Title
President/Ceo
Phone
(855) 830-8346

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 Physician 2086S0129X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1100 Johnson Fy Rd NE Ste 165
Atlanta, GA 30342-1795

Mailing address

7474 Greenway Center Dr Ste 1000
Greenbelt, MD 20770-3500
Phone (855) 830-8346

Other practice location 1

3886 Princeton Lakes Way SW Ste 140
Atlanta, GA 30331-5511
Phone (855) 830-8346

Other practice location 2

601 Professional Dr Ste 170
Lawrenceville, GA 30046-7649
Phone (855) 830-8346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201029000773 GA Part B Supplier - Clinic/Group Practice 8527478742 Receives reassigned benefits from 11 practitioners
Practice locations: Alpharetta, GA; Valdosta, GA; Marietta, GA; Lawrenceville, GA; Brunswick, GA; Atlanta, GA; Canton, GA
O20210226001127 GA DME Supplier - Physician - General PracticeDME Supplier - Medical Supply Company 8527478742 Practice locations: Atlanta, GA

Other NPIs with the same Medicare PAC ID 2

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

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Center for Vein Restoration Ga Corp1100 Johnson Fy Rd NE, Atlanta, GA 30342-1795(855) 830-8346 Surgical Dressings|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Oct 12, 2020

National Provider Directory

National Provider Directory

Locations

3400 Old Milton Pkwy
Ste A360
Alpharetta, GA 30005
Phone (770) 475-0077

601 Professional Dr
Ste 130
Lawrenceville, GA 30046
Phone (678) 551-7800

Practitioners & affiliated clinicians

Practitioners 11

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": "1593561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1902423387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7474 GREENWAY CENTER DR STE 1000",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703500",
            "telephone_number": "855-830-8346",
            "fax_number": "240-473-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE STE 165",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421795",
            "telephone_number": "855-830-8346",
            "fax_number": "240-473-4321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3886 Princeton Lakes Way SW Ste 140",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303315511",
            "country_code": "US",
            "telephone_number": "855-830-8346",
            "fax_number": "240-473-4321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Professional Dr Ste 170",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467649",
            "country_code": "US",
            "telephone_number": "855-830-8346",
            "fax_number": "240-473-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR VEIN RESTORATION GA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-01",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "LAKHANPAL",
        "authorized_official_first_name": "SANJIV",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "855-830-8346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.