Individual provider Active NPI

Carlos R Vigil, DO

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1366494015
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A7446 Issued in CA
Practice address
7974 Haven Ave
Suite 210
Rancho Cucamonga, CA 91730
Phone
(909) 941-0661
Fax
(909) 948-5577
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A7446 CA Primary

Addresses

Primary practice location

7974 Haven Ave
Suite 210
Rancho Cucamonga, CA 91730

Mailing address

7974 Haven Ave
Suite 210
Rancho Cucamonga, CA 91730
Phone (909) 941-0661

Other identifiers 1

IdentifierTypeStateIssuer
00AX74460MedicaidCA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050412001093 CA Practitioner - Internal Medicine 8921045816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Hospitalist IncGroup PAC ID 5092814038, 17 clinicians

Practice addresses (Care Compare)

7974 Haven Ave
Suite 210
Rancho Cucamonga, CA 91730-3052
Phone (909) 941-0661

Hospital & facility affiliations

  • Priority One Home Health Services Inc Home health agency, Montclair, CA, CCN 058063
  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carlos R. Vigil, D.O. (a Professional Corporation) CurrentSince Aug 1, 2000 Accepting new patients
United Hospitalist Inc. Internal Medicine CurrentSince May 1, 2007 Accepting new patients

Locations

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

255 E Bonita Ave
Bldg 1
Pomona, CA 91767
Phone (909) 524-1940

7974 Haven Ave
Ste 210
Rch Cucamonga, CA 91730
Phone (909) 941-0661

Organizations & group practices 2

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 2

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366494015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "SUITE 210",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-941-0661",
            "fax_number": "909-948-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "SUITE 210",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-941-0661",
            "fax_number": "909-948-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGIL",
        "first_name": "CARLOS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A7446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX74460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.