Individual provider Active NPI

Manuel Angel Vega Camis, M.D.

  • General Practice Physician
  • San Lorenzo, PR
National Provider Identifier
1104803600
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15450 Issued in PR
Practice address
Calle Jose de Diego 115
San Lorenzo, PR 00754-0000
Phone
(787) 937-7031
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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 15450 PR Primary

Addresses

Primary practice location

Calle Jose de Diego 115
San Lorenzo, PR 00754-0000

Mailing address

211 Calle Esparta
Urb. Olympic Court
Las Piedras, PR 00771-9019
Phone (787) 983-7741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000538 PR Practitioner - General Practice 6305800962 Reassigns benefits to 1 organization
Practice locations: San Lorenzo, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15450PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HM Health Care LLC General Practice CurrentSince Sep 30, 2023 Accepting new patients

Locations

115 Calle de Diego
San Lorenzo, PR 00754
Phone (787) 306-8519

Organizations & group practices 1

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1104803600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CALLE ESPARTA",
            "address_2": "URB. OLYMPIC COURT",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007719019",
            "telephone_number": "787-983-7741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE JOSE DE DIEGO 115",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "007540000",
            "telephone_number": "787-937-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA CAMIS",
        "first_name": "MANUEL",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Lorenzo, PR

Sources for this page

Verify at the official NPI Registry.