Individual provider Active NPI

Otto M Vega

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1437189214
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME86878 Issued in FL
Practice address
11501 SW 40TH St
Miami, FL 33165-3313
Phone
(305) 642-5366
NPI assigned
Jul 4, 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 ME86878 FL Primary

Addresses

Primary practice location

11501 SW 40TH St
Miami, FL 33165-3313

Mailing address

11501 SW 40TH St
Miami, FL 33165-3313
Phone (305) 642-5366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070227000741 FL Practitioner - Emergency MedicinePractitioner - Internal Medicine 2264534981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leon Medical Centers LLCGroup PAC ID 9537066618, 108 clinicians

Practice addresses (Care Compare)

7950 NW 2ND St
Miami, FL 33126-8017
Phone (305) 907-4147

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leon Medical Centers LLC CurrentSince Dec 25, 2020 Accepting new patients

Locations

8600 NW 41st St
Doral, FL 33166
Phone (305) 642-1511

2020 W 64th St
Hialeah, FL 33016
Phone (305) 631-5924

11501 SW 40th St
Miami, FL 33165
Phone (305) 646-3716

7950 NW 2nd St
Miami, FL 33126
Phone (305) 552-8822

11501 SW 40th St
Fl 2
Miami, FL 33165

Organizations & group practices 1

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437189214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11501 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653313",
            "telephone_number": "305-642-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653313",
            "telephone_number": "305-642-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "OTTO",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME86878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.