Individual provider Active NPI

Omayra M. Quijano-Vega, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Harrisburg, PA
National Provider Identifier
1619032174
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME109479 Issued in FL
Practice address
600 N 2ND St
Harrisburg, PA 17101-1092
Phone
(434) 248-7508
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME109479 FL Primary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X ME109479 FL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X M1299 TX

Addresses

Primary practice location

600 N 2ND St
Harrisburg, PA 17101-1092

Mailing address

8 Edwin LN
Palm Coast, FL 32164-6357

Other practice location 1

5718 Westheimer rd
Ste 1000
Houston, TX 77057
Phone (434) 248-7508

Other practice location 2

1667 North Clyde Morris Blvd
Suite 2
Daytona Beach, FL 32117
Phone (434) 248-7508

Other identifiers 2

IdentifierTypeStateIssuer
1619032174OtherFLTRICARE
14E4COtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110719000845 FL Practitioner - Internal MedicinePractitioner - Endocrinology 4183648587 Reassigns benefits to 1 organization
I20181126002167 OH Practitioner - Endocrinology 4183648587 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M1299TXMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nautilus Health Care Group LLC Undersea and Hyperbaric Medicine CurrentSince Nov 18, 2018 Accepting new patients
Nautilus Health Care Group, LLC Undersea and Hyperbaric Medicine CurrentSince Nov 18, 2018 Accepting new patients
Vera Endocrine Associates Inc CurrentSince Jul 31, 2017 Accepting new patients
Adena Medical Group LLC CurrentSince Nov 1, 2018 Accepting new patients
Chrysalis Health of Illinois P.C. Endocrinology, Diabetes & Metabolism Past Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients

Locations

1667 N Clyde Morris Blvd
#2
Daytona Beach, FL 32117
Phone (386) 274-1414

1120 Pinellas Bayway S
Ste 200
Tierra Verde, FL 33715
Phone (727) 867-5480

4439 State Route 159
Ste 150
Chillicothe, OH 45601
Phone (740) 779-4700

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Interoperability endpoints

  • Direct secure messaging: omayra.quijano-vega.1@19041.direct.athenahealth.com
  • Direct secure messaging: omayraquijanovega@fhcpfl.allscriptsdirect.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1619032174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 EDWIN LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321646357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N 2ND ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171011092",
            "telephone_number": "434-248-7508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5718 Westheimer rd",
            "address_2": "Ste 1000",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77057",
            "country_code": "US",
            "telephone_number": "434-248-7508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1667 North Clyde Morris Blvd",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "32117",
            "country_code": "US",
            "telephone_number": "434-248-7508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUIJANO-VEGA",
        "first_name": "OMAYRA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME109479",
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ME109479",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "M1299",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1619032174",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14E4C",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.