Individual provider Active NPI

Isael Vanegas, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1063298685
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
69197 Issued in TX
Practice address
1518 Freeman St
Houston, TX 77009-8511
Phone
(832) 338-2268
NPI assigned
Sep 8, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 69197 TX Primary

Addresses

Primary practice location

1518 Freeman St
Houston, TX 77009-8511

Mailing address

1518 Freeman St
Houston, TX 77009-8511
Phone (832) 338-2268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240302000243 TX Practitioner - Clinical Social Worker 1759726524 Reassigns benefits to 1 organization
Practice locations: Houston, TX
I20250113000216 OR Practitioner - Clinical Social Worker 1759726524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Broadway Medical Clinic LLPGroup PAC ID 2466447610, 18 clinicians
Cascadia HealthGroup PAC ID 7618873761, 53 clinicians

Practice addresses (Care Compare)

4212 NE Broadway
Portland, OR 97213-1422
Phone (503) 249-8787

4212 SE Division St
Suite 100
Portland, OR 97206-1680
Phone (503) 236-7166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Broadway Medical Clinic LLP CurrentSince Feb 1, 2025 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Apr 15, 2024 Accepting new patients
Cascadia Health CurrentSince Feb 9, 2026 Accepting new patients
Cascadia Health CurrentSince Feb 9, 2026 Accepting new patients

Locations

4212 NE Broadway
Portland, OR 97213
Phone (503) 249-8787

4212 SE Division St
Ste 100
Portland, OR 97206
Phone (503) 238-0705

707 NW Everett St
Portland, OR 97209
Phone (503) 222-4906

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: isael.vanegas.p1@direct.broadwaymedical.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1063298685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 FREEMAN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770098511",
            "telephone_number": "832-338-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 FREEMAN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770098511",
            "telephone_number": "832-338-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANEGAS",
        "first_name": "ISAEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "69197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.