Individual provider Active NPI

Daniel V. Vigil, MD

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1184795155
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G76613 Issued in CA
Practice address
1920 Colorado Ave
Santa Monica, CA 90404-3414
Phone
(310) 319-4700
Fax
(310) 453-5106
NPI assigned
Nov 13, 2006
Last updated
Nov 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G76613 CA Primary
Sports Medicine (Family Medicine) Physician 207QS0010X G76613 CA

Addresses

Primary practice location

1920 Colorado Ave
Santa Monica, CA 90404-3414

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

7515 Van Nuys Blvd
Van Nuys, CA 91405-1949
Phone (818) 947-4095

Other practice location 2

1250 16th St Ste 2100
Santa Monica, CA 90404-1249
Phone (310) 319-1234

Other identifiers 1

IdentifierTypeStateIssuer
1184795155MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100622000796 CA Practitioner - Family PracticePractitioner - Sports Medicine 5092846881 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Harvard Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UC RegentsGroup PAC ID 9739083866, 36 clinicians

Practice addresses (Care Compare)

1920 Colorado Ave
Santa Monica, CA 90404-3414
Phone (310) 319-4700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G76613CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Sports Medicine CurrentSince May 1, 2013 Accepting new patients
County of Los Angeles CurrentSince Jun 1, 2016 Accepting new patients
UC Regents Family Medicine CurrentSince Feb 1, 2013 Accepting new patients
County of Los Angeles CurrentSince Jun 1, 2016 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince May 1, 2013 Accepting new patients
County of Los Angeles Current Accepting new patients
UCLA Medical Group Family Medicine Past Accepting new patients
UCLA Family Practice Family Medicine Past Accepting new patients
Riverside Medical Group PC Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1108 N Oleander Ave
Compton, CA 90222
Phone (310) 763-2244

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

File 54206
Los Angeles, CA 90074

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

1250 16th St
Ste 2100
Santa Monica, CA 90404
Phone (424) 259-6593

1920 Colorado Ave
Santa Monica, CA 90404
Phone (310) 319-4700

7515 Van Nuys Blvd
Van Nuys, CA 91405
Phone (818) 627-3000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dvigil29215@direct.uclahealth.org

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1184795155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 COLORADO AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904043414",
            "telephone_number": "310-319-4700",
            "fax_number": "310-453-5106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7515 Van Nuys Blvd",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914051949",
            "country_code": "US",
            "telephone_number": "818-947-4095",
            "fax_number": "818-947-4027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 16th St Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041249",
            "country_code": "US",
            "telephone_number": "310-319-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIGIL",
        "first_name": "DANIEL",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G76613",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "G76613",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184795155",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.