Individual provider Active NPI

Federico E. Vaca, MD

  • Emergency Medicine Physician
  • New Haven, CT
National Provider Identifier
1649364902
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
047775 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-2222
Fax
(203) 688-3027
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 000000A52737 CA
Emergency Medicine Physician 207P00000X 047775 CT Primary
Sports Medicine (Emergency Medicine) Physician 207PS0010X 047775 CO

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

464 Congress Ave
Suite 260
New Haven, CT 06519-1361
Phone (203) 785-2353

Other identifiers 1

IdentifierTypeStateIssuer
00A527370OtherCAMEDI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000000A52737CAMDEmergency Medicine Physician
047775CTMDEmergency Medicine Physician
047775COMDSports Medicine (Emergency Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1649364902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 CONGRESS AVE",
            "address_2": "SUITE 260",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191361",
            "telephone_number": "203-785-2353",
            "fax_number": "203-785-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2222",
            "fax_number": "203-688-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACA",
        "first_name": "FEDERICO",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "000000A52737",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "047775",
            "primary": true
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "CO",
            "license": "047775",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A527370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.