NPIMap

Organization Active NPI

Visavis Health Care Medical Group of TX PLLC

  • Family Medicine Physician
  • Vernon, TX
National Provider Identifier
1518779792
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VISAVIS HEALTH CARE MEDICAL GROUP OF TX PLLC
Practice address
4401 College Dr
Vernon, TX 76384-4004
Phone
(877) 210-2373
NPI assigned
Jan 23, 2025
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Irina Yuffa
Title
VP Patient Care Services and Succes
Phone
(877) 210-2373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4401 College Dr
Vernon, TX 76384-4004

Mailing address

1481 McDonald Ave
Brooklyn, NY 11230-4667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250227003681 TX Part B Supplier - Clinic/Group Practice 7012437437 Receives reassigned benefits from 29 practitioners
Practice locations: Vernon, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1518779792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 MCDONALD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 COLLEGE DR",
            "city": "VERNON",
            "state": "TX",
            "postal_code": "763844004",
            "telephone_number": "877-210-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISAVIS HEALTH CARE MEDICAL GROUP OF TX PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "YUFFA",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "VP PATIENT CARE SERVICES AND SUCCES",
        "authorized_official_telephone_number": "877-210-2373"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.

Verify at the official NPI Registry.