North Shore Vascular Surgery, PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

NORTH SHORE VASCULAR SURGERY, PC

Practice address

620 Belle Terre Rd
Suite No. 2
Port Jefferson, NY 11777-2500

Phone

(631) 524-5960

Fax

(631) 524-5963

NPI assigned

May 5, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Ahmad F Bhatti, MD, RVT, FACSNPI 1598783953

Title

Vascular Surgeon / Owner

Phone

(631) 805-5956

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11535/brand/1/csg/1/fhir/r4

Practitioners 2

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

• Ahmad F Bhatti, MD

  • Vascular Surgery Physician
  • Port Jefferson, NY
  • NPI 1598783953

  NY, Vascular Surgery

  Medicare reassignment NPD Authorized official
• Norman R Bennett, M.D.

  • Internal Medicine Physician
  • Port Jefferson, NY
  • NPI 1700857786
  NPD

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1962889345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BELLE TERRE RD",
            "address_2": "SUITE NO. 2",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772500",
            "telephone_number": "631-524-5960",
            "fax_number": "631-524-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BELLE TERRE RD",
            "address_2": "SUITE NO. 2",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772500",
            "telephone_number": "631-524-5960",
            "fax_number": "631-524-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE VASCULAR SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "BHATTI",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VASCULAR SURGEON / OWNER",
        "authorized_official_telephone_number": "631-805-5956",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, RVT, FACS"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Benjamin O'Brien
• Marie O'Brien, ANP

• All providers in Port Jefferson, NY
• Vascular Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.