Angela Heather Vediz, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2003002304 Issued in MO

Practice address

2829 S Jackson Ave
Joplin, MO 64804-2525

Phone

(417) 624-0440

Fax

(417) 624-9652

NPI assigned

Oct 13, 2005

Last updated

Aug 8, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Skin Cancer Specialists LLCGroup PAC ID 5294721486, 44 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatology and Skin Cancer Specialists, LLC

  • Dermatology Physician
  • Leawood, KS
  • NPI 1205880846
  Medicare reassignment Care Compare group NPD
• Dermatology and Skin Cancer Specialists, LLC.

  dba Dermatology and Skin Cancer Center - Lee's Summit

  • Dermatology Physician
  • Lee's Summit, MO
  • NPI 1366632697
  Medicare reassignment
• Skin & Mohs Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Lee's Summit, MO
  • NPI 1881875227
  NPD
• Skin & Mohs Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Leawood, KS
  • NPI 1669577524
  NPD

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1629066659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 S JACKSON AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042525",
            "telephone_number": "417-624-0440",
            "fax_number": "417-624-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 S JACKSON AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648042525",
            "telephone_number": "417-624-0440",
            "fax_number": "417-624-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDIZ",
        "first_name": "ANGELA",
        "middle_name": "HEATHER",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2003002304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Christine Vanlue, NP-C
• Chandrasekhar R Vasamreddy, M.D.
• Jessica M. Vaughan
• Vanessa L Vaughan
• Vcphcs XV, LLC
• Franklin Benton Veer Jr., DO
• Lisa Vela, RN
• Tatiana Celines Velazquez
• Jairo Abinadi Verduzco
• Jessica L Verheyen, NP

• Physician Assistant in Joplin, MO
• Providers in Joplin, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.