Botond A Vita, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2460 Issued in CO

Practice address

2115 Stuart Ave
Alamosa, CO 81101-2269

Phone

(719) 589-8091

Fax

(719) 589-8112

NPI assigned

Sep 15, 2006

Last updated

Aug 14, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  NPD (past)
• Wheeling Hospital, Inc.

  • Anesthesiology Physician
  • Wheeling, WV
  • NPI 1922282581
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1134225592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BLANCA AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012340",
            "telephone_number": "719-589-3000",
            "fax_number": "719-587-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 STUART AVE",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012269",
            "telephone_number": "719-589-8091",
            "fax_number": "719-589-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITA",
        "first_name": "BOTOND",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "00380",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "2460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MTN HEALTH PLANS",
            "identifier": "840255530069",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "VIVI2460",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56582722",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jazmin Vigil, LPC, CAC III
• Melvin Vigil
• Patrick J Vigil
• Rashel C Villagomez, ACC
• Leova Villalobos
• Angela Waggoner, RN
• Wal-Mart
• Wal-Mart Stores, Inc. (Vision Center 30-0869)
• Walgreen Co (Walgreens #09912)
• Walgreen Co. (Walgreens #9912)

• Physician Assistant in Alamosa, CO
• Providers in Alamosa, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.