Individual provider Active NPI

Humberto H De la Vega, MD

  • Family Medicine Physician
  • Brownsville, TX
National Provider Identifier
1417933102
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K6836 Issued in TX
Practice address
4365 N Expressway # 7783
Suite 800
Brownsville, TX 78520-4857
Phone
(956) 548-6666
Fax
(956) 548-6667
NPI assigned
Dec 15, 2005
Last updated
Apr 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K6836 TX Primary

Addresses

Primary practice location

4365 N Expressway # 7783
Suite 800
Brownsville, TX 78520-4857

Mailing address

1474 W Price Rd # 602
Brownsville, TX 78520-8687
Phone (956) 548-6666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060726000241 TX Practitioner - Family Practice 3870506421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4365 S
83 Suite 800
Brownsville, TX 78520
Phone (956) 548-6666

4365 S
83 Suite 800
Brownsville, TX 78520-8489

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K6836TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M & M North, LLP Family Medicine CurrentSince Aug 1, 2006 Accepting new patients
M & M Pediatrics, PLLC Past Accepting new patients

Locations

1474 W Price Rd
#602
Brownsville, TX 78520
Phone (956) 465-1193

3354 International Blvd
Brownsville, TX 78521
Phone (956) 548-6666

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1417933102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1474 W PRICE RD # 602",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208687",
            "telephone_number": "956-548-6666",
            "fax_number": "956-548-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4365 N EXPRESSWAY # 7783",
            "address_2": "SUITE 800",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785204857",
            "telephone_number": "956-548-6666",
            "fax_number": "956-548-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA VEGA",
        "first_name": "HUMBERTO",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K6836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.