Active NPI
James Vegrzyn
- Dentist
- Chelsea, MA
National Provider Identifier
1558953877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7382
- Practice address
- 100 Heard St Unit 457
Chelsea, MA 02150-1972 - Phone
- (630) 962-4605
- NPI assigned
- Feb 8, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 7382 | LA | Primary |
Addresses
Primary practice location
100 Heard St Unit 457
Chelsea, MA 02150-1972
Mailing address
100 Heard St Unit 457
Chelsea, MA 02150-1972
Phone (630) 962-4605
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210720001611 | LA | Order and Referring Only - Dentist | 0042613630 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7382 | LA | MD | Speech-Language Pathologist |
Interoperability endpoints
- jvegrzyn5249538@direct.casso.us.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1558953877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HEARD ST UNIT 457",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021501972",
"telephone_number": "630-962-4605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HEARD ST UNIT 457",
"city": "CHELSEA",
"state": "MA",
"postal_code": "021501972",
"telephone_number": "630-962-4605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEGRZYN",
"first_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-08",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "7382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chelsea, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.