Wilson Andres Vasconez Samaniego, MD

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

74412 Issued in AZ

Practice address

1800 Orleans St RM 11379
Baltimore, MD 21287-0010

Phone

(410) 614-5055

Fax

(410) 955-0028

NPI assigned

Mar 23, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Phoenix Children'S Hospital

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1164926002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST RM 11379",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "410-614-5055",
            "fax_number": "410-955-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST RM 11379",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "410-614-5055",
            "fax_number": "410-955-0028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-933-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASCONEZ SAMANIEGO",
        "first_name": "WILSON",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "AZ",
            "license": "74412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryll Varquez
• Abigail Mary Varughese
• Roma Vasa, M.D.
• Sagar Vasandani
• Tiffani Lynn Vasco
• Vascular Institute of Maryland Surgical Center, PC
• Vascular Institute of Maryland, LLC
• Vascular Specialty Services, LLC
• Vascular Specialty Services, LLC
• Vascular Specialty Services, LLC

• Pediatric Hematology & Oncology Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatric Hematology & Oncology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.