NPIMap

Individual provider Active NPI

Larry P Vigilia

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1629275474
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A38814 Issued in CA
Practice address
1141 E Colorado St
Glendale, CA 91205-1308
Phone
(818) 956-1141
Fax
(818) 547-4392
NPI assigned
Jun 27, 2007
Last updated
Mar 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A38814 CA Primary

Addresses

Primary practice location

1141 E Colorado St
Glendale, CA 91205-1308

Mailing address

1141 E Colorado St
Glendale, CA 91205-1308
Phone (818) 356-1141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080524000066 CA Practitioner - Family PracticePractitioner - General Practice 5991874398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
J and D Healthcare IncGroup PAC ID 3072871243, 2 clinicians

Practice addresses (Care Compare)

1111 N Brand Blvd
Suite 310
Glendale, CA 91202-3071
Phone (818) 956-1141

9635 Monte Vista Ave
Suite 205
Montclair, CA 91763-2235
Phone (909) 906-3446

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A38814CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J & D Healthcare Inc CurrentSince Mar 1, 2023 Accepting new patients
Urgent Health Clinic Medical Group Inc Family Medicine CurrentSince Jan 1, 1983 Accepting new patients

Locations

1111 N Brand Blvd
Ste 310
Glendale, CA 91202
Phone (818) 956-1141

1141 E Colorado St
Glendale, CA 91205
Phone (818) 621-5000

9635 Monte Vista Ave
Ste 204
Montclair, CA 91763
Phone (909) 906-3446

9635 Monte Vista Ave
Ste 205
Montclair, CA 91763
Phone (909) 449-9328

2740 N Garey Ave
Ste 100
Pomona, CA 91767
Phone (909) 392-3230

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7953/brand/1/csg/1/fhir/r4
  • Direct secure messaging: larry.vigilia.1@7953.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Colorado River Home HealthNorthridge, CA, CCN 757166 Home health agency Corporate Director (100%) Mar 1, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1629275474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051308",
            "telephone_number": "818-356-1141",
            "fax_number": "818-547-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051308",
            "telephone_number": "818-956-1141",
            "fax_number": "818-547-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGILIA",
        "first_name": "LARRY",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A38814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.