Individual provider Active NPI

Roger Martin Vega Blanco, M.D.

  • Internal Medicine Physician
  • Stockbridge, GA
National Provider Identifier
1376983114
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
77322 Issued in GA
Practice address
1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone
(404) 367-3014
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME151274 FL
Hospitalist Physician 208M00000X 77322 GA
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 77322 GA Primary

Addresses

Primary practice location

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085

Mailing address

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-5901

Other practice location 1

8201 W Broward Blvd
Plantation, FL 33324-2701
Phone (877) 832-2652

Other practice location 2

180 JFK Dr Ste 210
Atlantis, FL 33462-6641
Phone (561) 548-1450

Other practice location 3

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 765-7000

Other practice location 4

1611 NW 12th Ave
Miami, FL 33136-1005
Phone (877) 832-2652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20170714001298 GA Practitioner - Internal Medicine 0648540294 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians
Piedmont Hospitalist Physicians LLCGroup PAC ID 1951299163, 503 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

Hospital & facility affiliations

  • Central Home Health Care, an Amedisys Company Home health agency, Douglasville, GA, CCN 117050
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME151274FLMDInternal Medicine Physician
77322GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Hospitalist Physicians LLC Internal Medicine CurrentSince Dec 28, 2022 Accepting new patients
North Atlanta Professional Services LLC Hospitalist CurrentSince Aug 26, 2021 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
Gwinnett Physician Group, LLC Internal Medicine CurrentSince Aug 26, 2021 Accepting new patients
Piedmont Hospitalist Physicians LLC Internal Medicine CurrentSince Dec 28, 2022 Accepting new patients
Piedmont Athens Specialty Care LLC Past Accepting new patients
Piedmont Henry Hospital, Inc. Past Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 7

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 3

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1376983114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "678-604-5901",
            "fax_number": "678-604-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "404-367-3014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8201 W Broward Blvd",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333242701",
            "country_code": "US",
            "telephone_number": "877-832-2652",
            "fax_number": "800-792-9021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 JFK Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Atlantis",
            "state": "FL",
            "postal_code": "334626641",
            "country_code": "US",
            "telephone_number": "561-548-1450",
            "fax_number": "561-548-1459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312173838",
            "country_code": "US",
            "telephone_number": "478-765-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "877-832-2652",
            "fax_number": "800-792-9021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEGA BLANCO",
        "first_name": "ROGER",
        "middle_name": "MARTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME151274",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "77322",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "77322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.