Active NPI
Johanan Vargas, M.D.
- Pediatrics Physician
- Brooksville, FL
National Provider Identifier
1649628124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME142061
- Practice address
- 11375 Cortez Blvd
Brooksville, FL 34613-5409 - Phone
- (407) 385-0545
- NPI assigned
- May 25, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 142061 | FL | |
| Pediatrics Physician | 208000000X | ME142061 | FL | Primary |
Addresses
Primary practice location
11375 Cortez Blvd
Brooksville, FL 34613-5409
Mailing address
14 Mangrove CT S
Homosassa, FL 34446-4507
Phone (407) 745-1577
Other practice location 1
1650 Grand Concourse
Bronx, NY 10457-7606
Phone (718) 590-1800
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221019002137 | FL | Practitioner - Pediatric Medicine | 5597131391 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 142061 | FL | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Medical Group Inc | Pediatrics | Current | Accepting new patients |
| Tampa General Hospital | Current | Accepting new patients | |
| Florida Hospital Medical Group Inc | Current | Accepting new patients |
Locations
900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255
2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700
Interoperability endpoints
- jvargas974397@adventhealth.direct-ci.com
- jvargas154417@direct.tgh.org
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Orlando, FL
- NPI 1225034234
FL, Pediatrics
-
- Prosthetic/Orthotic Supplier
- Minneola, FL
- NPI 1285591545
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675123200000",
"number": "1649628124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 MANGROVE CT S",
"city": "HOMOSASSA",
"state": "FL",
"postal_code": "344464507",
"telephone_number": "407-745-1577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11375 CORTEZ BLVD",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346135409",
"telephone_number": "407-385-0545"
}
],
"practiceLocations": [
{
"address_1": "1650 Grand Concourse",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104577606",
"country_code": "US",
"telephone_number": "718-590-1800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VARGAS",
"first_name": "JOHANAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-25",
"last_updated": "2023-01-31",
"certification_date": "2023-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "FL",
"license": "142061",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME142061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooksville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.