Organization Active NPI

Visa Vascular Care PC

  • Vascular Surgery Physician
  • New York, NY
National Provider Identifier
1922716455
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VISA VASCULAR CARE PC
Practice address
166 E 88TH St
New York, NY 10128-2255
Phone
(212) 433-4421
NPI assigned
Nov 14, 2022
Last updated
Mar 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Authorized official

Name
Vicken Nichan Pamoukian, MDNPI 1174587760
Title
Owner
Phone
(212) 433-4421

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

166 E 88TH St
New York, NY 10128-2255

Mailing address

515 E 79TH St Apt 23B
New York, NY 10075-0780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240223000074 NY Part B Supplier - Clinic/Group Practice 5991149445 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY; Garden City, NY; Brooklyn, NY; Elmhurst, NY; Astoria, NY; Bellmore, NY

National Provider Directory

National Provider Directory

Locations

2351 Bedford Ave
Bellmore, NY 11710
Phone (516) 781-5070

115 Nassau Ave
Brooklyn, NY 11222
Phone (718) 389-2121

1041 3rd Ave
Ste 200
New York, NY 10065
Phone (212) 362-3470

Practitioners & affiliated clinicians

Practitioners 3

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": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1922716455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E 79TH ST APT 23B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 E 88TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282255",
            "telephone_number": "212-433-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISA VASCULAR CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "PAMOUKIAN",
        "authorized_official_first_name": "VICKEN",
        "authorized_official_middle_name": "NICHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-433-4421",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.