Individual provider Active NPI

Constantine T. Andrew, M.D.

  • Vascular Surgery Physician
  • Rego Park, NY
National Provider Identifier
1992754063
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
340071 Issued in NY
Practice address
9836 Queens Blvd Ste 401
Rego Park, NY 11374-4257
Phone
(800) 991-6117
Fax
(888) 812-8191
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 036177654 IL
Phlebology Physician 202K00000X 036177654 IL
Surgery Physician 208600000X 25MA05096600 NJ
Phlebology Physician 202K00000X 340071 NY
Vascular Surgery Physician 2086S0129X 25MA05096600 NJ
Vascular Surgery Physician 2086S0129X 340071 NY Primary

Addresses

Primary practice location

9836 Queens Blvd Ste 401
Rego Park, NY 11374-4257

Mailing address

3820 Northdale Blvd Ste 201
Tampa, FL 33624-1893
Phone (800) 991-6117

Other practice location 1

2554 W Fabyan Pkwy
Batavia, IL 60510-1572
Phone (856) 428-7700

Other identifiers 2

IdentifierTypeStateIssuer
5130000MedicaidNJ
08425972MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, GA, NY3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20071121000449 NJ Practitioner - Vascular SurgeryPractitioner - General Surgery 4486548427 Reassigns benefits to 2 organizations
I20260319002031 GA Practitioner - Vascular Surgery 4486548427 Reassigns benefits to 1 organization
I20260618002525 NY Practitioner - Vascular Surgery 4486548427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Eastern Virginia Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

1105 Laurel Oak Rd
Voorhees, NJ 08043-4312

1600 Haddon Ave
Camden, NJ 08103-3101

1935 Route 70 E
Cherry Hill, NJ 08003-2117
Phone (856) 428-7700

3242 Route 206
Bordentown, NJ 08505-4517

570 Egg Harbor Rd
Sewell, NJ 08080-2359

90 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 247-7260

Hospital & facility affiliations

  • Virtua Home Care at West Jersey Home health agency, Marlton, NJ, CCN 317071
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal18
Leg revascularization (restoring blood flow)22
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05096600NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Apr 1, 2016 Accepting new patients
Virtua Medical Group, PA Surgery Current Accepting new patients
Georgia Uvc Medical LLC Phlebology CurrentSince Mar 1, 2026 Accepting new patients
Illinois Uvc Medical PLLC Surgery CurrentSince Jun 1, 2026 Accepting new patients
Cooper Surgical Associates, PA Surgery CurrentSince Jan 23, 2017 Accepting new patients
New York Medical United PLLC Surgery CurrentSince Jun 1, 2026 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Jan 23, 2017 Accepting new patients
Georgia Medical United LLC Vascular Surgery CurrentSince Mar 1, 2026 Accepting new patients
Virtua Medical Group, PA CurrentSince Apr 1, 2016 Accepting new patients

Locations

3820 Northdale Blvd
Ste 201
Tampa, FL 33624

3810 Northdale Blvd
Ste 260
Tampa, FL 33624

371 E Paces Ferry Rd NE
Ste 630
Atlanta, GA 30305

354 Newnan Crossing Byp
Ste 210
Newnan, GA 30265

1360 Caduceus Way
Ste 101
Watkinsville, GA 30677
Phone (706) 310-7115

2554 W Fabyan Pkwy
Batavia, IL 60510
Phone (630) 757-8120

1259 Rickert Dr
Ste 208
Naperville, IL 60540
Phone (331) 249-4007

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

1935 Route 70 E
Cherry Hill, NJ 08003
Phone (856) 246-3920

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

239 Hurffville Crosskeys Rd
Ste 350A
Sewell, NJ 08080
Phone (856) 589-0300

9836 Queens Blvd
Ste 401
Rego Park, NY 11374

Interoperability endpoints

  • Direct secure messaging: candrew17848@directvirtua.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1992754063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 NORTHDALE BLVD STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241893",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9836 QUEENS BLVD STE 401",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744257",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2554 W Fabyan Pkwy",
            "address_purpose": "LOCATION",
            "city": "Batavia",
            "state": "IL",
            "postal_code": "605101572",
            "country_code": "US",
            "telephone_number": "856-428-7700",
            "fax_number": "856-325-4196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDREW",
        "first_name": "CONSTANTINE",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036177654",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "IL",
            "license": "036177654",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA05096600",
            "primary": false
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "NY",
            "license": "340071",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA05096600",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "340071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5130000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08425972",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.