Individual provider Active NPI

Michael Hale Vagts, M.D.

  • Psychiatry Physician
  • San Mateo, CA
National Provider Identifier
1215223193
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A122112 Issued in CA
Practice address
222 W 39TH Ave
San Mateo, CA 94403-4364
Phone
(650) 573-2530
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A122112 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

222 W 39TH Ave
San Mateo, CA 94403-4364

Mailing address

222 W 39TH Ave
San Mateo, CA 94403-4364

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
I20121105000068 CA Practitioner - Psychiatry 7315198165 Reassigns benefits to 1 organization
Practice locations: Burlingame, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, Geffen School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

225 Cabrillo Hwy S
Half Moon Bay, CA 94019
Phone (650) 573-2222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A122112CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Sep 1, 2012 Accepting new patients
County of San Mateo CurrentSince Sep 1, 2012 Accepting new patients
County of San Mateo Current Accepting new patients

Locations

375 89th St
Daly City, CA 94015
Phone (650) 301-8650

225 Cabrillo Hwy S
Half Moon Bay, CA 94019
Phone (650) 726-0211

802 Brewster Ave
Redwood City, CA 94063
Phone (650) 363-4111

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

1950 Alameda de las Pulgas
San Mateo, CA 94403
Phone (650) 573-3571

Organizations & group practices 3

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1215223193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W 39TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 39TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034364",
            "telephone_number": "650-573-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAGTS",
        "first_name": "MICHAEL",
        "middle_name": "HALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A122112",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.