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VASCULAR COSMETICS LA
NPI 1366912446
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Irvine, CA

Active since November 30, 2018
112 WATERWORKS WAY, SUITE 140, IRVINE, CA 92618(949) 636-7775 Get Directions Write a Review

NPPES record last updated: July 2, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 2, 2025, Feb 3, 2023, Nov 30, 2018 (3 updates tracked since 2018).

About Vascular Cosmetics La NPPES

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

VASCULAR COSMETICS LA (NPI 1366912446) is a healthcare organization registered as a thoracic surgery (cardiothoracic vascular surgery) in Irvine, California and active in the NPI registry since November 2018. The organization maintains 2 additional practice locations and lists Reza Khodaverdian, President, as its authorized official.

NPPES Registry Identity

NPI1366912446
Entity TypeOrganization
Primary Taxonomy208G00000X
Legal Business NameVASCULAR COSMETICS LA
Location Address112 WATERWORKS WAY, SUITE 140Irvine, CA 92618-3168
Mailing Address19 Heather Hill LnLaguna Hills, CA 92653-6043 · (801) 641-1344 · Fax (818) 484-8243
Phone(949) 636-7775
Organization SubpartNo
Authorized OfficialReza KhodaverdianPresident · (949) 636-7775
Enumeration DateNovember 30, 2018
Last NPPES UpdateJuly 2, 20253 updates tracked since enumeration
NPPES CertifiedJune 17, 2025
✔ NPI 1366912446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians
Taxonomy Code208G00000X
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
112 WATERWORKS WAY, Irvine, CA 92618
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Secondary Practice Locations 2

Location 11511 W Glenoaks BlvdGlendale, CA 91201-1912 · Phone (818) 482-0016 · Fax (818) 484-8243
Location 2319 S Brand BlvdGlendale, CA 91204-1701 · Phone (818) 482-0016 · Fax (818) 484-8243

Other Identifiers 1

OtherA127413CA · Med License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vascular Cosmetics La is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Vascular Cosmetics La, which bills Medicare for the services this clinician delivers.

Clinician (1)

Reza Khodaverdian, M.D.
Cardiac Surgery
NPI 1700050689
113 WATERWORKS WAY STE 140
Irvine, CA 92618
(949) 932-0053
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Vascular Cosmetics La's NPI number?

The NPI number for Vascular Cosmetics La is 1366912446. It was assigned to this organization in the NPPES registry on November 30, 2018.

Where is Vascular Cosmetics La located?

Vascular Cosmetics La is located at 112 Waterworks Way Suite 140, Irvine, CA 92618. The listed phone number is (949) 636-7775.

What is Vascular Cosmetics La's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Vascular Cosmetics La enrolled in Medicare?

Yes. Vascular Cosmetics La is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Vascular Cosmetics La?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Cardiac Surgery) reassigns their Medicare billing to Vascular Cosmetics La. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Vascular Cosmetics La was last updated on July 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.