| Pacific Vascular Institute, Llc | |
|
99-115 Aiea Heights Dr Ste 276b Aiea HI 96701-3924 | |
| (352) 870-7393 | |
| Not Available |
| Full Name | Pacific Vascular Institute, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 99-115 Aiea Heights Dr Ste 276b, Aiea, Hawaii |
| Authorized Official Name and Position | Hardeep Reddick (MANAGER) |
| Authorized Official Contact | 8059757463 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Vascular Institute, Llc 99-115 Aiea Heights Dr Ste 276b Aiea HI 96701-3924 Ph: (352) 870-7393 | Pacific Vascular Institute, Llc 99-115 Aiea Heights Dr Ste 276b Aiea HI 96701-3924 Ph: (352) 870-7393 |
| NPI Number | 1275167348 |
|---|---|
| Provider Enumeration Date | 02/27/2020 |
| Last Update Date | 10/26/2020 |
| Medicare PECOS PAC ID | 2365852381 |
|---|---|
| Medicare Enrollment ID | O20201103001713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275167348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Russell N Harada |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1730143884 PECOS PAC ID: 8527081389 Enrollment ID: I20060106000451 |
| Provider Name | Michael Shin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720234180 PECOS PAC ID: 6800911926 Enrollment ID: I20100914000087 |
| Provider Name | Ajay Bhatt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164606646 PECOS PAC ID: 5193841559 Enrollment ID: I20100923000540 |
| Provider Name | Nathan P Tomita |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255312401 PECOS PAC ID: 5698758340 Enrollment ID: I20120803000218 |
| Provider Name | Ammaar El-sergany |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669766747 PECOS PAC ID: 3375764251 Enrollment ID: I20141017000497 |
| Provider Name | Kelly M Marshall |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295094662 PECOS PAC ID: 3779809728 Enrollment ID: I20150310001123 |
| Provider Name | Amr El-sergany |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1639484603 PECOS PAC ID: 0042523789 Enrollment ID: I20170821002185 |
| Provider Name | Jonelee Badua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578035671 PECOS PAC ID: 7618218397 Enrollment ID: I20190405001176 |
| Provider Name | Ali Yasser El Sergany |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871650002 PECOS PAC ID: 8729413943 Enrollment ID: I20200116001854 |
| Provider Name | Cole Koichi Nishikawa |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1245611912 PECOS PAC ID: 5496184582 Enrollment ID: I20200413001230 |
| Provider Name | Nathan K Itoga |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1366880098 PECOS PAC ID: 1850715749 Enrollment ID: I20200715002121 |
| Provider Name | Cherryl A Menapace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073028981 PECOS PAC ID: 7416219779 Enrollment ID: I20201026002637 |
| Provider Name | Horng J Lin |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1255395398 PECOS PAC ID: 8921062969 Enrollment ID: I20210811000771 |
| Provider Name | Richard Parsons |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1396813283 PECOS PAC ID: 8426030099 Enrollment ID: I20211230001269 |
| Provider Name | Delaram Taghipour |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407271521 PECOS PAC ID: 0042509648 Enrollment ID: I20220208001456 |
| Provider Name | James Antezana |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1134174436 PECOS PAC ID: 4688684012 Enrollment ID: I20230125003298 |
| Provider Name | Robert Mcmurray |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1275971772 PECOS PAC ID: 8123358975 Enrollment ID: I20230307001268 |
| Provider Name | Nicole Yazdanpour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417669532 PECOS PAC ID: 9436524576 Enrollment ID: I20230404000309 |
| Provider Name | Stephanie Lynn Silvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275396863 PECOS PAC ID: 4587000351 Enrollment ID: I20240314003636 |
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