Vascular Institute of Georgia, PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

VASCULAR INSTITUTE OF GEORGIA, PC

Practice address

5669 Peachtree Dunwoody Rd NE
Suite 100
Atlanta, GA 30342-1786

Phone

(404) 256-0404

Fax

(404) 847-0423

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark J Mittenthal, M.D.NPI 1598739559

Title

Physician

Phone

(404) 256-0404

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 1

• Vascular Insitute of Georiga, PC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark J. Mittenthal, MD

  • Vascular Surgery Physician
  • Atlanta, GA
  • NPI 1598739559
  NPD (past) Authorized official

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932167269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5669 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421786",
            "telephone_number": "404-256-0404",
            "fax_number": "404-847-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5669 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421786",
            "telephone_number": "404-256-0404",
            "fax_number": "404-847-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR INSTITUTE OF GEORGIA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITTENTHAL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "404-256-0404",
        "authorized_official_name_prefix": "Mr.",
        "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "J. MARK RHEUDASIL",
            "identifier": "1033184767",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00216466H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARK G. COAN",
            "identifier": "1861466955",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00460039E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALAN KOORNICK",
            "identifier": "1376517300",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHAEL D. CLARK",
            "identifier": "1528028925",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00206005I",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PETER H'DOUBLER JR.",
            "identifier": "1629038476",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARK MITTENTHAL",
            "identifier": "1598739559",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vascular Insitute of Georiga, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Juhi Varshney
• Payaswini Vasanth, M.D.
• Vasaya Health LLC
• Katie Dee Vasconez, CNP
• Vascular Institute of Georgia at Saint Joseph'S, LLC
• Aksal Pankaj Vashi
• Dipak V Vashi, MD
• Vason Dental, LLC
• Carlisle Hamilton Vason, DMD
• James Hamilton Vason, D.D.S., PC

• Vascular Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.