Active NPI
Rafael Anibal Vargas, D.C
- Chiropractor
- Elmhurst, NY
National Provider Identifier
1407897697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CO 19382
- Practice address
- 4019 76TH St
Elmhurst, NY 11373-1033 - Phone
- (718) 424-8484
- Fax
- (718) 424-0630
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CO 19382 | NY | Primary |
Addresses
Primary practice location
4019 76TH St
Elmhurst, NY 11373-1033
Mailing address
4019 76TH St
Elmhurst, NY 11373-1033
Phone (718) 424-8484
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G300000075 | Other | NPPES, PTAN | |
| CHI000470-0 | Other | NY | VNS |
| N778218 | Other | NY | WELLCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090127000386 | NY | Practitioner - Chiropractic | 0840354478 | Practice locations: Elmhurst, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO 19382 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414368000000",
"number": "1407897697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4019 76TH ST",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731033",
"telephone_number": "718-424-8484",
"fax_number": "718-424-0630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4019 76TH ST",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113731033",
"telephone_number": "718-424-8484",
"fax_number": "718-424-0630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARGAS",
"first_name": "RAFAEL",
"middle_name": "ANIBAL",
"name_prefix": "Dr.",
"credential": "D.C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2014-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "CO 19382",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPPES, PTAN",
"identifier": "G300000075",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VNS",
"identifier": "CHI000470-0",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "N778218",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.