MODERN VASCULAR AND VEIN CENTER LLC – Vascular & Interventional Radiology Physician, NPI 1487176004
Vascular & Interventional Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MODERN VASCULAR AND VEIN CENTER LLC
244 W Central Ave
Lombard, IL 601483813
Phone: (219) 208-6218
Fax: (219) 359-3679
Type: Location
951 Transport Dr
Valparaiso, IN 463838434
Phone: (574) 213-1327
Fax: (475) 275-8031
Type: Location
951, Transport Drive, Valparaiso, Porter County, Indiana, 46383, United States
VALPARAISO, IN 463838434
Phone: (574) 213-1327
Fax: (475) 275-8031
Type: Location
244, West Central Avenue, Flowerfield, Lombard, DuPage County, Illinois, 60148, United States
LOMBARD, IL 601483813
Phone: (219) 208-6218
Fax: (219) 359-3679
Type: Mailing
8127 MERRILLVILLE RD STE 1
MERRILLVILLE, IN 464106306
Phone: (219) 208-6218
Fax: (475) 275-8031
Type: Location
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: 2020-01-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (982 days ago).
Enrollment records
2
Earliest due date
2023-09-30
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 |
|---|---|---|---|---|
| O20170802003474 | O | Clinic/Group Practice | IN | 2023-09-30 |
| O20200129002634 | O | Clinic/Group Practice | IL | 2025-07-31 |
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 60148)
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