Individual provider Active NPI

Edgar Z Vanegas, MD

  • Family Medicine Physician
  • Jamaica, NY
National Provider Identifier
1316034820
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
190283-1 Issued in NY
Practice address
8505 167TH St
Jamaica, NY 11432-2621
Phone
(718) 658-7482
Fax
(718) 658-7531
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 190283-1 NY Primary

Addresses

Primary practice location

8505 167TH St
Jamaica, NY 11432-2621

Mailing address

8505 167TH St
Jamaica, NY 11432-2621
Phone (718) 658-7482

Other identifiers 1

IdentifierTypeStateIssuer
01369786MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040407000133 NY Practitioner - Family Practice 5890686992 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

2510 30TH Ave
Astoria, NY 11102-2448
Phone (718) 932-1000

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
190283-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Hospital CurrentSince Dec 20, 2010 Accepting new patients
The Mount Sinai Hospital CurrentSince Dec 20, 2010 Accepting new patients
Icahn School of Medicine at Mount Sinai Family Medicine CurrentSince Mar 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2016 Accepting new patients
Westbury Family Medical Family Medicine PastSince Mar 27, 2003 Accepting new patients
James J. Di Maio, MD, PC Past Accepting new patients

Locations

2715 30th Ave
Long Island City, NY 11102
Phone (718) 267-4808

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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.

Hospital & facility affiliations 6

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1316034820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8505 167TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322621",
            "telephone_number": "718-658-7482",
            "fax_number": "718-658-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8505 167TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322621",
            "telephone_number": "718-658-7482",
            "fax_number": "718-658-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANEGAS",
        "first_name": "EDGAR",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "190283-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01369786",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.