Individual provider Active NPI

Gladys Perez Vega, MD

  • Internal Medicine Physician
  • Bayamon, PR
National Provider Identifier
1215040027
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5609 Issued in PR
Practice address
Condominio Las Torres Sur Calle Isleta
Suite 3a
Bayamon, PR 00959-3569
Phone
(787) 740-3558
Fax
(787) 787-8133
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5609 PR Primary

Addresses

Primary practice location

Condominio Las Torres Sur Calle Isleta
Suite 3a
Bayamon, PR 00959-3569

Mailing address

PO Box 3569
Bayamon Gardens Station
Bayamon, PR 00958
Phone (787) 740-3558

Other identifiers 1

IdentifierTypeStateIssuer
26435OtherPRSSS

Other names 1

  • Gladys Perez Vega Professional name

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
I20110504000578 PR Practitioner - Internal Medicine 3072798107 Practice locations: Bayamon, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5609PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1215040027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3569",
            "address_2": "BAYAMON GARDENS STATION",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00958",
            "telephone_number": "787-740-3558",
            "fax_number": "787-787-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CONDOMINIO LAS TORRES SUR CALLE ISLETA",
            "address_2": "SUITE 3A",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009593569",
            "telephone_number": "787-740-3558",
            "fax_number": "787-787-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ VEGA",
        "first_name": "GLADYS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "5609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "26435",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLADYS",
            "last_name": "VEGA",
            "middle_name": "PEREZ",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bayamon, PR

Sources for this page

Verify at the official NPI Registry.