Individual provider Active NPI

Aixa E Vega Rodriguez

  • Clinical Medical Laboratory
  • Hatillo, PR
National Provider Identifier
1609942093
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
Carr 490 KM 3.0 HM 0.5
Hatillo, PR 00659-1218
Phone
(787) 820-5508
Fax
(787) 820-5508
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X 3390 PR
Clinical Medical Laboratory 291U00000X PR Primary

Addresses

Primary practice location

Carr 490 KM 3.0 HM 0.5
Hatillo, PR 00659-1218

Mailing address

PO Box 1218
Hatillo, PR 00659-1218
Phone (787) 820-5508

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080618000798 PR Part B Supplier - Independent Clinical Laboratory 5799856787 Practice locations: Hatillo, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1609942093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1218",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006591218",
            "telephone_number": "787-820-5508",
            "fax_number": "787-820-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 490 KM 3.0 HM 0.5",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006591218",
            "telephone_number": "787-820-5508",
            "fax_number": "787-820-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA RODRIGUEZ",
        "first_name": "AIXA",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "PR",
            "license": "3390",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatillo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.