NPIMap

Individual provider Active NPI

Jose Carlos Vanegas Perez, MD

  • Infectious Disease Physician
  • Flushing, NY
National Provider Identifier
1285131441
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
1285131441 Issued in NY
Practice address
5645 Main St
Flushing, NY 11355-5045
Phone
(718) 678-2000
NPI assigned
Apr 12, 2018
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PR
Infectious Disease Physician 207RI0200X 1285131441 NY Primary

Addresses

Primary practice location

5645 Main St
Flushing, NY 11355-5045

Mailing address

1388 Calle Castellana
Ponce, PR 00730-4055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611002900 CO Practitioner - Infectious Disease 8426590035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1800 15TH St
Greeley, CO 80631-4563

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

2000 Boise Ave
Loveland, CO 80538-5006
Phone (970) 820-4640

4700 Lady Moon Dr
Fort Collins, CO 80528-4426

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1285131441NYMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC Current Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Jul 1, 2024 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Jul 1, 2024 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

1800 15th St
Ste 210
Greeley, CO 80631
Phone (970) 352-8216

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

Organizations & group practices 4

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1285131441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1388 CALLE CASTELLANA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007304055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MAIN ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113555045",
            "telephone_number": "718-678-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANEGAS PEREZ",
        "first_name": "JOSE",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "1285131441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.