Unknown Individual – Vascular Surgery Physician, NPI 1508869579
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
East Lancaster Avenue, Wynnewood, Lower Merion Township, Montgomery County, Pennsylvania, 19066, United States
WYNNEWOOD, PA 190963449
Phone: (610) 565-8564
Fax: (610) 565-3046
Type: Mailing
1098 W Baltimore Pike
Suite 3308 Riddle Health Center 3
Media, PA 190635139
Phone: (610) 565-8564
Fax: (610) 565-3046
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 114 Open Payments records for all available years, with a total value of $19,417.
Total Amount is formed as General ($19,417) + Research ($0) + Ownership ($0) = $19,417.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Bolton Medical Inc ($11,829).
Total Amount
$19,417
General + Research + Ownership
Payments
114
Total payment records
General Amount
$19,417
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bolton Medical Inc | $11,829 |
| Penumbra, Inc. | $2,467 |
| Endologix LLC | $2,317 |
| Cook Medical LLC | $373 |
| Terumo Medical Corporation | $350 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 317 | 236 | $0 |
| 93971 | Ultrasound study of one arm or leg veins with compression and maneuvers | 91 | 85 | $0 |
| 93922 | Ultrasound study of arm and leg arteries | 90 | 87 | $0 |
| 93970 | Ultrasound study of arm or leg veins with compression and maneuvers | 86 | 85 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 75 | 75 | $0 |
Insurance plans in this area (ZIP 19096)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | PA | 93926 | Ultrasound study of arteries and arterial grafts of one leg or limited | 15 | 15 |
| GENERAL SURGERY | PA | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 143 | 132 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | PA | |
| Family Practice | PA | |
| - | PA | |
| General Surgery | PA | |
| - | PA | |
| - | PA | |
| Internal Medicine | PA | |
| Internal Medicine | PA | |
| - | PA | |
| Family Practice, Geriatric Medicine | PA |
Reviews
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