Jerry Charles Vega

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

59492 Issued in CA

Practice address

66675 Pierson Blvd
Desert Hot Springs, CA 92240-3737

Phone

(760) 676-5240

NPI assigned

Sep 21, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dap Health IncGroup PAC ID 6002989522, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Angels Home Health Corporation Home health agency, Palm Springs, CA, CCN 059598

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jvega684934@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dap Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Palm Springs, CA
  • NPI 1306464326
  Medicare reassignment Care Compare group
• MH 7 LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Phoenix, AZ
  • NPI 1710255088
  Medicare reassignment
• Dap Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Cathedral City, CA
  • NPI 1386180404
  NPD
• Dap Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Anza, CA
  • NPI 1942623657
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1013568088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E CEDAR AVE STE A-3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041630",
            "telephone_number": "928-774-2788",
            "fax_number": "928-774-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66675 PIERSON BLVD",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922403737",
            "telephone_number": "760-676-5240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 E Cedar Ave Ste A-3",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860041630",
            "country_code": "US",
            "telephone_number": "928-774-2788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEGA",
        "first_name": "JERRY",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-21",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7657",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "59492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Victor Valdivia
• Alexis Valenzuela
• Sonja Van Clief
• Tonja Lynn Vaughan, BEHAVIOR TECHNICIAN
• Karina Vazquez Cazarez
• Ashley Christine Verral
• Esperanza Iri Villareal
• Christie Dawn Vincent
• Diane Judith Vogt
• Vons Companies Inc

• Medical Physician Assistant in Desert Hot Springs, CA
• Providers in Desert Hot Springs, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.