Individual provider Active NPI

Jose Antonio Vega Peralta, M.D.

  • Gastroenterology Physician
  • Plymouth, MN
National Provider Identifier
1447427588
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
55180 Issued in MN
Practice address
15700 37TH Ave N Ste 300
Plymouth, MN 55446-3661
Phone
(612) 624-5915
Fax
(612) 624-1473
NPI assigned
May 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 55180 MN Primary

Addresses

Primary practice location

15700 37TH Ave N Ste 300
Plymouth, MN 55446-3661

Mailing address

PO Box 14909
Minneapolis, MN 55414-0909
Phone (612) 871-1114

Other practice location 1

516 Delaware St SE
Minneapolis, MN 55455-0356
Phone (612) 624-5915

Other identifiers 1

IdentifierTypeStateIssuer
18660OtherMNINTERNAL MEDICINE RESIDENT PERMIT NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20120905000638 MN Practitioner - GastroenterologyPractitioner - Internal Medicine 7012164544 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mngi Digestive Health PAGroup PAC ID 8123016557, 276 clinicians

Practice addresses (Care Compare)

15700 37TH Ave N
Suite 300
Plymouth, MN 55446-3661
Phone (612) 871-1145

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy112
Upper gastrointestinal (GI) endoscopy for acid reflux117

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Aug 24, 2012 Accepting new patients
Mngi Digestive Health, P.a. Gastroenterology CurrentSince Mar 6, 2018 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Aug 24, 2012 Accepting new patients

Locations

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

15700 37th Ave N
Ste 300
Plymouth, MN 55446
Phone (612) 870-5555

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jose.vegaperalta.p1@direct.mngastro.nextgenshare.com

Organizations & group practices 5

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 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1447427588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14909",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554140909",
            "telephone_number": "612-871-1114",
            "fax_number": "612-870-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 37TH AVE N STE 300",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463661",
            "telephone_number": "612-624-5915",
            "fax_number": "612-624-1473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 Delaware St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550356",
            "country_code": "US",
            "telephone_number": "612-624-5915",
            "fax_number": "612-624-1473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEGA PERALTA",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-08",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "55180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL MEDICINE RESIDENT PERMIT NUMBER",
            "identifier": "18660",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.