VASCULAR SURGERY ASSOCIATES PA (NPI# 1083894836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083894836 |
| Entity Type | Organization |
| Organization Name | VASCULAR SURGERY ASSOCIATES PA |
| Practice Address |
3887 Coon Rapids Blvd Nw Coon Rapids MN 55433-2518 |
| Practice Telephone | 7634278547 |
| Practice Fax Number | 7635765394 |
| Mailing Telephone | 7634278547 |
| Mailing Fax Number | 7635765394 |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2014-12-29 |
| Authorized Official Name | MR. CRAIG STUART WALVATNE (PHYSICIAN) |
| Authorized Official Telephone | 7634278547 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
31967 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1778251 | 05 |
| Street Address |
3887 COON RAPIDS BLVD NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689074155 | Stephanie Rae Walvatne | Nurse Practitioner | 3887 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2518 | 2014-09-02 |
| 1447583331 | Laura Elizabeth Heydt | Physician Assistant | 3887 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2518 | 2009-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265721757 | Yauhen Alexander Tarbunou | Surgery | 1200 6th Ave. N., St. Cloud, MN 56303-2735 | 2011-04-05 |
| 1215947288 | Kamran Karimi | Surgery | 6405 France Ave S Ste W320, Edina, MN 55435-2188 | 2006-08-09 |
| 1649217159 | Roger S Hogue | Surgery | 7365 Kirkwood Ct N, Ste 120, Maple Grove, MN 55369-4721 | 2006-06-01 |
| 1720025455 | Rumi Faizer | Surgery | 314 Variety Club Research Center, 401 East River Parkway Division of Vascular Surgery, Minneapolis, MN 55455 | 2006-06-01 |
| 1518938067 | David Reed Knighton | Surgery | 2460 Highway 100 S, St Louis Park, MN 55416-1704 | 2006-01-31 |
| 1679100937 | Jesse Chait | Surgery | 200 1st St Sw, Rochester, MN 55905-0002 | 2020-03-26 |
| 1699235689 | Armin Farazdaghi | Surgery | 200 First Street Sw, Rochester, MN 55905-0001 | 2019-03-25 |
| 1093210262 | Nolan C Cirillo-penn | Surgery | 200 1st St Sw, Rochester, MN 55905 | 2018-03-28 |
| 1760915862 | Indrani Sen | Surgery | 200 1st St Sw, Mayo Clinic, Rochester, Rochester, MN 55905-0001 | 2017-04-05 |
| 1306380571 | St. Luke's Hospital of Duluth | Surgery | 1000 E 1st St, Ste. 203, Duluth, MN 55805-2297 | 2016-12-07 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on VASCULAR SURGERY ASSOCIATES PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.