NPIMap

Organization Active NPI

Vega Baja Imaging LLC

  • Diagnostic Radiology Physician
  • Vega Baja, PR
National Provider Identifier
1265458558
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
VEGA BAJA IMAGING LLC
Practice address
3998 Carr 2
Vega Baja, PR 00693-4140
Phone
(787) 855-2687
Fax
(787) 858-8299
NPI assigned
Jul 13, 2006
Last updated
Sep 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Authorized official

Name
Jose Rossello Camacho
Title
Presidente
Phone
(787) 966-3882

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary
Vascular & Interventional Radiology Physician 2085R0204X
Diagnostic Ultrasound Physician 2085U0001X
General Practice Physician 208D00000X

Addresses

Primary practice location

3998 Carr 2
Vega Baja, PR 00693-4140

Mailing address

3998 Carr 2
Vega Baja, PR 00693-4140
Phone (787) 855-2687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050804001034 PR Part B Supplier - Clinic/Group Practice 0244269744 Receives reassigned benefits from 2 practitioners
Practice locations: Vega Baja, PR

National Provider Directory

National Provider Directory

Locations

3998 Carr 2
Ste 2
Vega Baja, PR 00693
Phone (787) 855-2687

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1265458558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 CARR 2",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006934140",
            "telephone_number": "787-855-2687",
            "fax_number": "787-858-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 CARR 2",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "006934140",
            "telephone_number": "787-855-2687",
            "fax_number": "787-858-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEGA BAJA IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "ROSSELLO CAMACHO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-966-3882"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.