Individual provider Active NPI

Madais Rodriguez-Vega, DC

  • Chiropractor
  • Port Orange, FL
National Provider Identifier
1124784434
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13741 Issued in FL
Practice address
830 Airport Rd Apt 210
Port Orange, FL 32128-7459
Phone
(787) 325-5775
NPI assigned
Nov 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13741 FL Primary

Addresses

Primary practice location

830 Airport Rd Apt 210
Port Orange, FL 32128-7459

Mailing address

830 Airport Rd Apt 210
Port Orange, FL 32128-7459
Phone (787) 325-5775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220217002867 FL Practitioner - Chiropractic 3779977673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. George Blackwell Inc.Group PAC ID 2769805225, 5 clinicians

Practice addresses (Care Compare)

1967 SE Port St Lucie Blvd
PSL Health Center
Port St Lucie, FL 34952-5536
Phone (772) 335-3110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH13741FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. George Blackwell Inc. Chiropractor CurrentSince Feb 1, 2022 Accepting new patients

Locations

1967 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 335-3110

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": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1124784434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 AIRPORT RD APT 210",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321287459",
            "telephone_number": "787-325-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 AIRPORT RD APT 210",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321287459",
            "telephone_number": "787-325-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-VEGA",
        "first_name": "MADAIS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.