Altagracia Adalgiza Victoria, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME-0070097 Issued in FL

Practice address

5801 NW 151St St Ste 203
Miami Lakes, FL 33014-2437

Phone

(305) 822-4447

Fax

(305) 822-4484

NPI assigned

May 10, 2006

Last updated

Oct 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Internal Medicine

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Victoria Medical Group IncGroup PAC ID 1658403589, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Victoria Medical Group Inc

  • Internal Medicine Physician
  • Miami Lakes, FL
  • NPI 1346321734
  Medicare reassignment Care Compare group NPD Authorized official
• Fardales Medical Center Inc

  • Primary Care Clinic/Center
  • Hialeah, FL
  • NPI 1174990915
  NPD
• Lisbet Rodriguez Boloix PA

  • Family Nurse Practitioner
  • Miami Lakes, FL
  • NPI 1619716495
  NPD

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1649220898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 NW 151ST ST STE 203",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142437",
            "telephone_number": "305-822-4447",
            "fax_number": "305-822-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 NW 151ST ST STE 203",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142437",
            "telephone_number": "305-822-4447",
            "fax_number": "305-822-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIA",
        "first_name": "ALTAGRACIA",
        "middle_name": "ADALGIZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME-0070097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250584300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME 0070097",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Viamontes Rodriguez
• Jose D Viana
• Vibrantsteps Therapy Inc
• Vibrantsteps Therapy Inc
• Victoria Medical Group Inc
• Vida Home Health Services LLC
• Vida Med Center LLC
• Vida Medical Care LLC
• Vida Medical Network LLC
• Vida Mental Health Services Inc

• Family Medicine Physician in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.