THEODORE S PABST III – NPI #1528208881
Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

THEODORE S PABST III is a surgeon located in PLATTSBURGH, NY. NPPES has assigned the NPI number 1528208881 to THEODORE S PABST III on February 26, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “THEODORE S PABST III” is a dba name, the actual legal business name for this organization is CHAMPLAIN VALLEY VASCULAR SURGERY. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2086S0129X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Vascular Surgery

The NPI profile was previously updated about 3 years ago on Mar 03, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for THEODORE S PABST III below.

NPI Profile for
CHAMPLAIN VALLEY VASCULAR SURGERY

NPI Number
1528208881
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHAMPLAIN VALLEY VASCULAR SURGERY
Doing Business As (dba): THEODORE S PABST III
Primary location
24 HAMMOND LANE
PLATTSBURGH, NY 12901
Phone: (518) 562-7557 Fax: (518) 562-7559
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
THEODORE PABST
CEO
Phone: (518) 562-7557
Updated
Certification Date
Mar 03, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for THEODORE S PABST III

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidNY01276613
medicaidNY04556089
medicaidNY01972430
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0129X
- Surgery / Vascular Surgery (Primary)
NY 203101-1
363LG0600X
- Nurse Practitioner / Gerontology

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.