NPIMap

Individual provider Active NPI

Myra Theresa Vargas, M.D.

  • Nephrology Physician
  • Hainesport, NJ
National Provider Identifier
1285683573
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MA 62484 Issued in NJ
Practice address
1261 Route 38
Suite a
Hainesport, NJ 08036-2702
Phone
(856) 222-1975
Fax
(856) 222-0721
NPI assigned
May 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MA 62484 NJ Primary

Addresses

Primary practice location

1261 Route 38
Suite a
Hainesport, NJ 08036-2702

Mailing address

1261 Route 38
Suite a
Hainesport, NJ 08036-2702
Phone (856) 222-1975

Other identifiers 2

IdentifierTypeStateIssuer
4624807MedicaidNH
6609805MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110627000072 NJ Practitioner - Nephrology 6406832500 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Albert Einstein College of Medicine of Yeshiva University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Center for Kidney Care, PCGroup PAC ID 3577549666, 13 clinicians
Professional Service Fund of Deborah Heart and Lung CenterGroup PAC ID 4284537499, 118 clinicians

Practice addresses (Care Compare)

1261 Route 38
Suite a
Hainesport, NJ 08036-2702
Phone (856) 222-1975

200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone (609) 893-6611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA 62484NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Kidney Care, P.C. Nephrology CurrentSince Sep 18, 1995 Accepting new patients
Professional Service Fund of Deborah- Anesthesia Current Accepting new patients
Professional Service Fund of Deborah Heart & Lung Center CurrentSince Sep 18, 1995 Accepting new patients
Haddon Renal Medical Specialists, PA Nephrology Past Accepting new patients

Locations

200 Trenton Rd
Browns Mills, NJ 08015
Phone (609) 893-1200

1900 Mount Holly Rd
Ste 4
Burlington, NJ 08016

1900 Mount Holly Rd
Ste 4D
Burlington Township, NJ 08016
Phone (856) 222-1975

1261 Route 38
#A
Hainesport, NJ 08036
Phone (856) 222-1975

Interoperability endpoints

  • Direct secure messaging: mvargas35766@direct.davitaphysiciansolutions.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1285683573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 ROUTE 38",
            "address_2": "SUITE A",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362702",
            "telephone_number": "856-222-1975",
            "fax_number": "856-222-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 ROUTE 38",
            "address_2": "SUITE A",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362702",
            "telephone_number": "856-222-1975",
            "fax_number": "856-222-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "MYRA",
        "middle_name": "THERESA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-06",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA 62484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4624807",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6609805",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hainesport, NJ

Sources for this page

Verify at the official NPI Registry.