Active NPI
Rene S Vasquez, M.D.
- Family Medicine Physician
- Deland, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 100810
- Practice address
- 929 N Spring Garden Ave Ste 170
Deland, FL 32720-0917 - Phone
- (386) 738-9144
- Fax
- (877) 245-1597
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 100810 | FL | Primary |
Addresses
Primary practice location
929 N Spring Garden Ave Ste 170
Deland, FL 32720-0917
Mailing address
6101 Blue Lagoon Dr Ste 400
Miami, FL 33126-2051
Phone (305) 500-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036052042 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rene.vasquez@conviva.eclinicaldirectplus.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 1969
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6101 Blue Lagoon Dr
Suite 400
Miami, FL 33126
6101 Blue Lagoon Dr
Suite 400
Miami, FL 33126-2051
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100810 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health & Hospitals Corporation | Current | Accepting new patients | |
| Conviva Medical Center Management LLC | Family Medicine | Current | Accepting new patients |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Metcare of Florida, Inc | Past | Accepting new patients | |
| Rene S Vasquez M D S C | Family Medicine | Past | Accepting new patients |
Locations
731 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 257-1626
929 N Spring Garden Ave
Ste 170
Deland, FL 32720
Phone (386) 738-3896
5238 Norwood Ave
#16
Jacksonville, FL 32208
Phone (904) 265-2050
4960 SW 72nd Ave
Ste 406
Miami, FL 33155
6101 Blue Lagoon Dr
Ste 400
Miami, FL 33126
Phone (305) 500-2114
6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836
595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944
135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
4025 N Western Ave
Chicago, IL 60618
Phone (773) 275-7700
6000 W Touhy Ave
Chicago, IL 60646
Phone (708) 390-5928
29373 Network Pl
Chicago, IL 60673
Interoperability endpoints
- rene.vasquez@conviva.eclinicaldirectplus.com
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Miami, FL
- NPI 1649324278
Family Medicine
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Family Medicine Physician
- Chicago, IL
- NPI 1932250610
-
- Medical Specialty Clinic/Center
- Oak Lawn, IL
- NPI 1912936014
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Internal Medicine Physician
- Hialeah, FL
- NPI 1902893225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1245391986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6101 BLUE LAGOON DR STE 400",
"city": "MIAMI",
"state": "FL",
"postal_code": "331262051",
"telephone_number": "305-500-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 N SPRING GARDEN AVE STE 170",
"city": "DELAND",
"state": "FL",
"postal_code": "327200917",
"telephone_number": "386-738-9144",
"fax_number": "877-245-1597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASQUEZ",
"first_name": "RENE",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2022-07-21",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "100810",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036052042",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rene.vasquez@conviva.eclinicaldirectplus.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "929 N Spring Garden Ave Ste 170",
"city": "Deland",
"state": "FL",
"country_code": "US",
"postal_code": "327200917",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Deland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.