Juan Angel Vega, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

238612 Issued in NY

Practice address

800 Red Mills Rd
Wallkill, NY 12589-3220

Phone

(845) 744-9105

Fax

(845) 744-9107

NPI assigned

Jul 7, 2006

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

Other identifiers 1

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.

Opted out of Medicare

Yes, effective Apr 1, 2014 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1073545984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 RED MILLS RD",
            "city": "WALLKILL",
            "state": "NY",
            "postal_code": "125893220",
            "telephone_number": "845-744-9105",
            "fax_number": "845-744-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 RED MILLS RD",
            "city": "WALLKILL",
            "state": "NY",
            "postal_code": "125893220",
            "telephone_number": "845-744-9105",
            "fax_number": "845-744-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "JUAN",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J9837",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "238612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110715302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toddler Genius Inc.
• Terri Lee Torchio
• To-Loan Thi Tran, D.M.D.
• Corina Tyrrell, LMT
• Upstate Ambulatory Service LLC
• Katherine Velez, PH.D.
• Louisner Victor
• Jennifer Wallingford, M.S., CCC-SLP
• Wallkill Central School District
• Wallkill Physical Therapy, PLLC

• Pediatrics Physician in Wallkill, NY
• Providers in Wallkill, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.