Individual provider Active NPI

Vanessa Vazquez Vergara, MD, MHA

  • General Practice Physician
  • Bayamon, PR
National Provider Identifier
1063392496
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
25165 Issued in PR
Practice address
70 Calle Santa Cruz
Bayamon, PR 00961-7052
Phone
(787) 620-4747
NPI assigned
Sep 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 25165 PR Primary

Addresses

Primary practice location

70 Calle Santa Cruz
Bayamon, PR 00961-7052

Mailing address

PO Box 236
Bayamon, PR 00960-0236
Phone (787) 620-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17347IPRMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1063392496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009600236",
            "telephone_number": "787-620-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 CALLE SANTA CRUZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617052",
            "telephone_number": "787-620-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ VERGARA",
        "first_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "MD, MHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-05",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "25165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.