SURGICAL SPECIALISTS, P.C. (NPI# 1780650465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780650465 |
| Entity Type | Organization |
| Organization Name | SURGICAL SPECIALISTS, P.C. |
| Practice Address |
11 Industrial Blvd Paoli Pointe Ste 102 Paoli PA 19301-1632 |
| Mailing Address |
Po Box 252 Bryn Mawr PA 19010-0252 |
| Practice Telephone | 6106473077 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RONALD J MATTSON (PRESIDENT OF CORPORATION) |
| Authorized Official Telephone | 6105271185 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| X | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0017456690001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053368696 | Surgical Specialists, P.C. | Surgery | 4700 Battlefield Pkwy, Suite 130, Ringgold, GA 30736-5166 | 2006-05-28 |
| Street Address |
11 INDUSTRIAL BLVD PAOLI POINTE STE 102 |
| City | PAOLI |
| State | PA |
| Zip Code | 19301-1632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487805230 | Suburban Audiology and Balance Center, LLC | Audiologist | 11 Industrial Blvd, Suite 102, Paoli, PA 19301-1632 | 2008-10-09 |
| 1295902823 | Great Valley Neurological Associates LLC | Psychiatry & Neurology | 11 Industrial Blvd, Suite 204, Paoli, PA 19301-1632 | 2008-05-13 |
| 1083812002 | Luis Blasco | Specialist | 11 Industrial Blvd, Suite 100, Paoli, PA 19301-1632 | 2007-07-11 |
| 1205960770 | Valerie W Godzieba | Nurse Practitioner | 11 Industrial Blvd, Suite 103, Paoli, PA 19301-1632 | 2007-03-15 |
| 1780742841 | Main Line Internal Medicine LLC | Internal Medicine | 11 Industrial Blvd, Suite 101, Paoli, PA 19301-1632 | 2006-12-04 |
| 1144396623 | Andrea Caprio | Physician Assistant | 11 Industrial Blvd, Paoli, PA 19301-1632 | 2006-11-28 |
| 1124120134 | Sara Kathleen Burelle | Internal Medicine | 11 Industrial Blvd, Suite 103, Paoli, PA 19301-1632 | 2006-09-01 |
| 1184633927 | Elana N. Kripke | Internal Medicine | 11 Industrial Blvd, Suite 101, Paoli, PA 19301-1632 | 2006-08-07 |
| 1831104496 | Becky A Souder | Family Medicine | 11 Industrial Blvd, Suite 103, Paoli, PA 19301-1632 | 2006-07-30 |
| 1356369086 | Stanton B. Miller | Preventive Medicine | 11 Industrial Blvd, Paoli Pointe Building, Suite 103, Paoli, PA 19301-1632 | 2006-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588280333 | Mary Callery | Physical Therapy Assistant | 16 Industrial Blvd., Ste. 101, Paoli, PA 19301 | 2020-06-17 |
| 1871097519 | Daniel Malloy-good | Social Worker | 45 Darby Rd Ste E4, Paoli, PA 19301 | 2018-03-19 |
| 1306354774 | Patricia Obilo-azandegbe | Counselor | 30 S Valley Rd Ste 101, Paoli, PA 19301 | 2018-01-18 |
| 1275992877 | Jessica Bernard | Physical Therapist | 40 Darby Rd Ste 1, Paoli, PA 19301 | 2016-02-11 |
| 1730576364 | Ushma Sheth | Podiatrist | 250 W Lancaster Ave Ste 225, Paoli, PA 19301 | 2015-04-21 |
| 1619371432 | Miriam Leslie Brewer | Physical Therapist | 195 W Lancaster Ave #3, Paoli, PA 19301 | 2014-10-22 |
| 1447665393 | Matthew Rementer | Podiatrist | 254 West Lancaster Ave, Paoli, PA 19301 | 2014-06-29 |
| 1720490915 | Edward Anthony Romero | Surgery | 255 W Lancaster Ave Ste 332, Paoli, PA 19301 | 2014-05-22 |
| 1285053421 | Jose Ethan Pulido | Urology | 2 Industrial Blvd Bldg C Ste 120, Paoli, PA 19301 | 2014-04-15 |
| 1093065849 | Kathleen M Canfield | Physician Assistant | 11 Industrial Blvd., Ste 204, Paoli Pointe Med. Office Bldg, Paoli, PA 19301 | 2012-09-19 |
| Find all providers in zip 19301 | ||||
| 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 |
|---|---|---|---|---|
| 1720630650 | Broad Street Professional Medical Services LLC | Surgery | 2033 S Broad St Ste A, Philadelphia, PA 19148-5505 | 2019-07-11 |
| 1124670922 | Broad Street Medical LLC | Surgery | 2033 S Broad St Ste B, Philadelphia, PA 19148-5505 | 2019-07-11 |
| 1932610755 | Vascular Surgical Specialists Pllc | Surgery | 1450 E Boot Rd Ste 600b, West Chester, PA 19380-5968 | 2017-10-19 |
| 1336515956 | Aria Health Physician Services | Surgery | 9501 Roosevelt Blvd Ste 312, Philadelphia, PA 19114-1028 | 2015-08-18 |
| 1437525490 | Advanced Vein and Laser Center Lancaster, LLC | Surgery | 896a Plaza Blvd, Lancaster, PA 17601-2745 | 2015-08-13 |
| 1447658877 | Center for Vein Restoration Pa Pllc | Surgery | 1338 Bristol Pike Ste 205, Bensalem, PA 19020-5679 | 2014-12-17 |
| 1023423167 | Catherine Go | Surgery | 420 S Aiken Ave, Apt A6, Pittsburgh, PA 15232-1226 | 2014-06-27 |
| 1659703635 | Walter J. Fagan | Surgery | 211 Center Ave, Jim Thorpe, PA 18229-1205 | 2013-08-01 |
| 1346521267 | Usa Vein Clinics of Philadelphia LLC | Surgery | 51 Cameron Rd, Huntingdon Valley, PA 19006-1401 | 2011-09-06 |
| 1124314893 | Nathan Loren Liang | Surgery | 200 Lothrop St # A-1017, Pittsburgh, PA 15213-2536 | 2011-06-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SURGICAL SPECIALISTS, P.C..
| 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.