Individual provider Active NPI

Julio Cesar Vasquez, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Pocatello, ID
National Provider Identifier
1497824007
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
M9688 Issued in ID
Practice address
777 Hospital Way
Pocatello, ID 83201-2753
Phone
(208) 239-2850
Fax
(208) 239-2589
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X M9688 ID Primary

Addresses

Primary practice location

777 Hospital Way
Pocatello, ID 83201-2753

Mailing address

777 Hospital Way Ste 215
Pocatello, ID 83201-5162
Phone (208) 239-2580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20070807000121 ID Practitioner - Thoracic SurgeryPractitioner - General Surgery 2567553415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1710

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal16
Leg revascularization (restoring blood flow)19
Removal of tissue141
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9688IDMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Hospital LLC Current Accepting new patients
Pocatello Health Services, LLC CurrentSince Apr 19, 2009 Accepting new patients
Pocatello Health Services, LLC CurrentSince Apr 19, 2009 Accepting new patients
Pocatello Health Services, LLC Current Accepting new patients

Locations

777 Hospital Way
Ste 101
Pocatello, ID 83201
Phone (208) 234-2001

777 Hospital Way
Ste 215
Pocatello, ID 83201
Phone (208) 239-2580

777 Hospital Way
Ste G11
Pocatello, ID 83201
Phone (208) 239-1710

444 Hospital Way
Ste 777
Pocatello, ID 83201
Phone (208) 233-4455

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000

777 Hospital Way
#G11
Pocatello, ID 83201
Phone (208) 239-1710

777 Hospital Way
Ste G1
Pocatello, ID 83201
Phone (208) 234-2001

Interoperability endpoints

  • Direct secure messaging: jvasquez179535@ahs.direct-ci.com

Organizations & group practices 4

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 5

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1497824007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY STE 215",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015162",
            "telephone_number": "208-239-2580",
            "fax_number": "208-239-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012753",
            "telephone_number": "208-239-2850",
            "fax_number": "208-239-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JULIO",
        "middle_name": "CESAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "ID",
            "license": "M9688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.