Individual provider Active NPI

Wilfredo I Vergara, MD

  • Pediatric Critical Care Medicine Physician
  • Huntsville, AL
National Provider Identifier
1366435398
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
27740 Issued in AL
Practice address
245 Governors Dr SE
Huntsville, AL 35801-2700
Phone
(256) 265-7981
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 01051701A IN
Pediatric Critical Care Medicine Physician 2080P0203X 27740 AL Primary
Pediatric Critical Care Medicine Physician 2080P0203X ME140266 FL

Addresses

Primary practice location

245 Governors Dr SE
Huntsville, AL 35801-2700

Mailing address

PO Box 2705
Huntsville, AL 35804-2705
Phone (256) 801-6047

Other practice location 1

11115 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone (260) 266-5400

Other practice location 2

1500 SW 10th Ave
Topeka, KS 66604-1301
Phone (785) 354-5242

Other practice location 3

5153 N 9th Ave
Pensacola, FL 32504-8785
Phone (850) 416-7710

Other identifiers 1

IdentifierTypeStateIssuer
009914158MedicaidAL

Electronic endpoints 5

TypeEndpointUseAffiliation
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
Direct Messaging Address wvergara679239@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/
Direct Messaging Address wvergara114321@stormontvaildirect.org Direct STORMONT-VAIL HEALTHCARE INC
Direct Messaging Address wvergara114321@stormontvaildirect.org Direct COTTON O'NEIL CLINIC REVOCABLE TRUST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, NV, AZ, MT, GA5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20080220000354 IN Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 7416926910 Reassigns benefits to 1 organization
I20201009002533 NV Practitioner - Pediatric Medicine 7416926910 Reassigns benefits to 1 organization
I20220919000833 AZ Practitioner - Critical Care (Intensivists) 7416926910 Reassigns benefits to 1 organization
I20240305004241 MT Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 7416926910 Reassigns benefits to 1 organization
I20250408001295 GA Practitioner - Pediatric Medicine 7416926910 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19035NVMDPharmacist
27740ALMDPediatric Critical Care Medicine Physician
01051701AINMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Ambulatory Healthcare Services, Inc. Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
SCL Health Medical Group - Billings, LLC CurrentSince Dec 19, 2023 Accepting new patients
TMC Medical Network CurrentSince Aug 10, 2022 Accepting new patients
Parkview Health System Inc Family Medicine CurrentSince Sep 7, 2025 Accepting new patients
SCL Health Medical Group - Billings LLC Current Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
SCL Health Medical Group - Billings, LLC CurrentSince Dec 19, 2023 Accepting new patients
Pokroy Medical Group of Nevada, LTD. Pediatric Critical Care Medicine CurrentSince Aug 25, 2020 Accepting new patients
SCL Health Montana Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
The Health Care Authority of the City of Huntsville Past Accepting new patients
Tooele Clinic Corp Family Medicine Past Accepting new patients

Locations

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

770 The City Dr S
Ste 7000
Orange, CA 92868

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

707 Center St
Ste 110
Columbus, GA 31901
Phone (706) 494-4300

1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11115 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-5400

240 S Jefferson St
Ste B
Huntington, IN 46750
Phone (219) 259-0000

2900 12th Ave N
Ste 140W
Billings, MT 59101
Phone (406) 237-5050

1233 N 30th St
Billings, MT 59101
Phone (406) 237-3850

16 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2205

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

Interoperability endpoints

  • Direct secure messaging: wvergara114321@stormontvaildirect.org
  • Direct secure messaging: wvergara679239@direct.parkviewexchange.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1366435398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042705",
            "telephone_number": "256-801-6047",
            "fax_number": "256-801-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 GOVERNORS DR SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358012700",
            "telephone_number": "256-265-7981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11115 Parkview Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451701",
            "country_code": "US",
            "telephone_number": "260-266-5400",
            "fax_number": "260-425-6745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 SW 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Topeka",
            "state": "KS",
            "postal_code": "666041301",
            "country_code": "US",
            "telephone_number": "785-354-5242",
            "fax_number": "785-354-6349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5153 N 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048785",
            "country_code": "US",
            "telephone_number": "850-416-7710",
            "fax_number": "850-416-6729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "WILFREDO",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "IN",
            "license": "01051701A",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AL",
            "license": "27740",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME140266",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009914158",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11115 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wvergara679239@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "11115 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "11115 Parkview Plaza Dr",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468451701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wvergara114321@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure messaging",
            "affiliationName": "STORMONT-VAIL HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1500 SW 10th Ave",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666041301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wvergara114321@stormontvaildirect.org",
            "affiliation": "Y",
            "endpointDescription": "SVH Secure messaging",
            "affiliationName": "COTTON O'NEIL CLINIC REVOCABLE TRUST",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1500 SW 10th Ave",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666041301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.