VASCULAR SURGICAL ASSOCIATES, PC – Vascular Surgery Physician, NPI 1114083532
Vascular Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for VASCULAR SURGICAL ASSOCIATES, PC
148 Bill Carruth Pkwy Ste 380
Hiram, GA 301413763
Phone: (770) 874-0703
Type: Location
3747 Roswell Rd Ste 316
Marietta, GA 300626227
Phone: (678) 626-5420
Type: Location
130, Stoneforest Drive, Deer Run at Towne Lake, Woodstock, Cherokee County, Georgia, 30189, United States
WOODSTOCK, GA 301894881
Phone: (770) 423-0595
Fax: (770) 423-0598
Type: Mailing
2041 Mesa Valley Way Ste 185
Austell, GA 301066856
Phone: (770) 944-8315
Type: Location
6095 Professional Pkwy Ste B203
Douglasville, GA 301345608
Phone: (770) 423-0595
Type: Location
962 Joe Frank Harris Pkwy SE Ste 202
Cartersville, GA 301202154
Phone: (770) 423-0595
Type: Location
130 Riverstone Ter Ste 100
Canton, GA 301141702
Phone: (770) 479-4800
Type: Location
61 WHITCHER ST NE STE 2100
MARIETTA, GA 300601179
Phone: (770) 423-0595
Fax: (770) 423-0598
Type: Location
60 CHASTAIN CENTER BLVD NW STE 66
KENNESAW, GA 301445598
Phone: (770) 423-0595
Fax: (770) 423-0598
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-03-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-01-31 (860 days ago).
Enrollment records
2
Earliest due date
2024-01-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040625000667 | O | Clinic/Group Practice | GA | 2024-01-31 |
| O20170331002080 | O | Physician - General Practice | GA | 2025-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30141)
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