Lisa L Vanegas-Diaz I, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16546 Issued in CA

Practice address

400 N Pepper Ave
Colton, CA 92324-1801

Phone

(909) 580-1000

NPI assigned

Jun 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Rehabilitation and Critical Care Medical Group, Inc.Group PAC ID 7911067582, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Pain Rehabilitation & Critical Care Medical Group, Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Colton, CA
  • NPI 1659569226
  Medicare reassignment Care Compare group
• Inland Empire Anesthesia Medical Group, Inc

  • Anesthesiology Physician
  • Colton, CA
  • NPI 1861502841
  Medicare reassignment

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

• County of San Bernardino

  • General Acute Care Hospital
  • Colton, CA
  • NPI 1720158009
  Care Compare affiliation

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1326084583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916030998",
            "telephone_number": "818-509-2222",
            "fax_number": "818-509-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANEGAS-DIAZ",
        "first_name": "LISA",
        "middle_name": "L",
        "name_suffix": "I",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA16546",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Obstetrics & Gynecology Medical Group, Inc.
• Valley Star Behavioral Health, Inc.
• Joseph Charles Van Campen
• Joanna T Van, DO
• Marion Van
• Kenneth Vang
• Nathan Johan Vanovereem
• Alejandro Varela, PA
• Belen M Vargas, RAS CAADE
• Cristina Brianna Vargas

• Physician Assistant in Colton, CA
• Providers in Colton, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.

Verify at the official NPI Registry.