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SOUTHEASTERN VASCULAR, P.C.
NPI 1205866274
Surgery - Vascular Surgery in Hyannis, MA

Active since July 04, 2006CLIA 22D0080998 · Waiver
100 CAMP ST, HYANNIS, MA 02601(508) 775-1984(508) 790-1897 Get Directions Write a Review

NPPES record last updated: August 30, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 24, 2021, May 21, 2021, May 11, 2021 and 1 more (4 updates tracked since 2020).

About Southeastern Vascular, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEASTERN VASCULAR, P.C. (NPI 1205866274), doing business as Southeastern Surgical Associates Pc, is a healthcare organization registered as a vascular surgery in Hyannis, Massachusetts and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026, maintains 2 additional practice locations, and lists Lynn Ellinwood, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1205866274
Entity TypeOrganization
Primary Taxonomy2086S0129X
Legal Business NameSOUTHEASTERN VASCULAR, P.C.
Location Address100 CAMP STHyannis, MA 02601-3007
Mailing Address100 Camp StHyannis, MA 02601-3007 · (508) 775-1984 · Fax (508) 790-1897
Phone(508) 775-1984
Fax(508) 790-1897
Organization SubpartNo
Authorized OfficialLynn EllinwoodPractice Manager · (508) 775-1984
Enumeration DateJuly 4, 2006
Last NPPES UpdateAugust 30, 20214 updates tracked since enumeration
NPPES CertifiedAugust 30, 2021
✔ NPI 1205866274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0129X
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Also ListedSurgeryTaxonomy 208600000X
100 CAMP ST, Hyannis, MA 02601
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Other Names 1

Former Legal Business NameSoutheastern Surgical Associates Pc

Secondary Practice Locations 2

Location 1800 Falmouth Rd Ste 102AMashpee, MA 02649-3363 · Phone (508) 775-1984
Location 220 Indian Hill RoadWest Tisbury, MA 02568 · Phone (508) 775-1984

Other Identifiers 2

Medicaid9776605MA
OtherSOM16224MA · Bcbs

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D0080998

Southeastern Vascular PC · Hyannis, MA
Active · expires Aug 31, 2026
CLIA Number22D0080998
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDaniel R. Gorin
Laboratory Phone(508) 775-1984
Laboratory LocationSoutheastern Vascular PC100 Camp Street, Hyannis, MA 02601
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALISON BRZOSKA MESSINA MD
Surgery (Vascular Surgery)
100 CAMP ST
HYANNIS, MA 02601
Barnstable County (508) 875-1984
DR. CARLOS A FONTS MD
Surgery
100 CAMP ST
HYANNIS, MA 02601
Barnstable County (508) 775-1984
DR. JEFFREY J SPILLANE MD
Surgery
100 CAMP ST
HYANNIS, MA 02601
Barnstable County (508) 428-6219
SOUTHEASTERN SURGICAL ASSOCIATES LLC
Surgery
100 CAMP ST
HYANNIS, MA 02601
Barnstable County (508) 775-1984
MRS. KATHIA P ROSA NP
Nurse Practitioner (Primary Care)
100 CAMP ST
HYANNIS, MA 02601
Barnstable County (508) 775-1984
DR. H WALTER KAESS MD
General Practice
100 CAMP ST
HYANNIS, MA 02601
Barnstable County (508) 775-1984
DR. ROGER CRAIG ROSEN M.D.
Surgery (Vascular Surgery)
100 CAMP ST
HYANNIS, MA 02601
Barnstable County (508) 775-1984
DONNA M POTTER NP
Nurse Practitioner (Adult Health)
100 CAMP ST
HYANNIS, MA 02601
Barnstable County (508) 775-1984

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeastern Vascular, P.C.'s NPI number?

The NPI number for Southeastern Vascular, P.C. is 1205866274. It was assigned to this organization in the NPPES registry on July 4, 2006. The provider was formerly known as Southeastern Surgical Associates PC.

Where is Southeastern Vascular, P.C. located?

Southeastern Vascular, P.C. is located at 100 Camp St, Hyannis, MA 02601. The listed phone number is (508) 775-1984.

What is Southeastern Vascular, P.C.'s specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Does Southeastern Vascular, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D0080998) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southeastern Vascular, P.C. accept?

Health plans from Anthem Blue Cross and Blue Shield, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Southeastern Vascular, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeastern Vascular, P.C. was last updated on August 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.