Individual provider Active NPI

Paul Vega, MD

  • Internal Medicine Physician
  • North Las Vegas, NV
National Provider Identifier
1548366875
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
8638 Issued in NV
Practice address
1815 E Lake Mead Blvd
Ste 100
North Las Vegas, NV 89030
Phone
(702) 657-1506
Fax
(702) 657-1583
NPI assigned
Sep 15, 2006
Last updated
Sep 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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 8638 NV Primary

Addresses

Primary practice location

1815 E Lake Mead Blvd
Ste 100
North Las Vegas, NV 89030

Mailing address

1815 E Lake Mead Blvd
Ste 100
North Las Vegas, NV 89030
Phone (702) 657-1506

Other identifiers 1

IdentifierTypeStateIssuer
2018135MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20110518000528 NV Practitioner - Internal Medicine 7810902988

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1548366875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 E LAKE MEAD BLVD",
            "address_2": "STE 100",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89030",
            "telephone_number": "702-657-1506",
            "fax_number": "702-657-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E LAKE MEAD BLVD",
            "address_2": "STE 100",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "89030",
            "telephone_number": "702-657-1506",
            "fax_number": "702-657-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "8638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018135",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.