Active NPI
USA Professional Medical Services of New York LLC
- Vascular Surgery Physician
- Ridgewood, NY
National Provider Identifier
1962895680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- Legal business name
- USA PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC
- Practice address
- 5920 Myrtle Ave
Ridgewood, NY 11385-5658 - Phone
- (718) 504-6364
- Fax
- (224) 246-8042
- NPI assigned
- Mar 5, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Yan Katsnelson, MD
- Title
- Director
- Phone
- (847) 257-1244
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | Primary | ||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X |
Addresses
Primary practice location
5920 Myrtle Ave
Ridgewood, NY 11385-5658
Mailing address
4141 Dundee Rd
Northbrook, IL 60062-2129
Phone (847) 257-1244
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Brooklyn, NY
- NPI 1811281439
-
- Surgical Oncology Physician
- Newton, NJ
- NPI 1720085707
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425513600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1425513600000",
"number": "1962895680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4141 DUNDEE RD",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622129",
"telephone_number": "847-257-1244",
"fax_number": "224-246-8042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5920 MYRTLE AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113855658",
"telephone_number": "718-504-6364",
"fax_number": "224-246-8042"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "USA PROFESSIONAL MEDICAL SERVICES OF NEW YORK LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-03-05",
"last_updated": "2015-03-05",
"status": "A",
"authorized_official_last_name": "KATSNELSON",
"authorized_official_first_name": "YAN",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "847-257-1244",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": null,
"license": null,
"primary": true
},
{
"code": "208G00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.