Individual provider Active NPI

Ricardo Vasquez, MD

  • Vascular Surgery Physician
  • Bloomington, IN
National Provider Identifier
1689622573
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
01062063A Issued in IN
Practice address
815 W 2ND St
Bloomington, IN 47403-2212
Phone
(812) 336-6008
Fax
(812) 339-6947
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 01062063A IN Primary

Addresses

Primary practice location

815 W 2ND St
Bloomington, IN 47403-2212

Mailing address

815 W 2ND St
Bloomington, IN 47403-2212
Phone (812) 336-6008

Other identifiers 7

IdentifierTypeStateIssuer
200818170OtherINMEDICAID GROUP
P00400660OtherINMEDICARE RAILROAD INDIVIDUAL
200818170AOtherINMEDICAID INDIVIDUAL
250940OtherINMEDICARE GROUP
517966OtherINANTHEM GROUP
000000517969OtherINANTHEM INDIVIDUAL
250940AOtherINMEDICARE INDIVIDUAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20060530000001 IN Practitioner - Vascular SurgeryPractitioner - General Surgery 3375539208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Iowa, RJ & L Carver College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

815 W 2ND St
Bloomington, IN 47403-2212
Phone (812) 336-6008

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.14 of 100Reported as individual
Quality
35
Improvement activities
40
Cost
98.33

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal77
Leg revascularization (restoring blood flow)22
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Center & Vein Clinic of Southern Indiana Vascular Surgery CurrentSince Jun 1, 2007 Accepting new patients
Vascular Surgery & Technology Vascular Surgery Past Accepting new patients

Locations

815 W 2nd St
Bloomington, IN 47403
Phone (812) 336-4947

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGFHDD/Endpoint/GGFHDD

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1689622573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032212",
            "telephone_number": "812-336-6008",
            "fax_number": "812-339-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032212",
            "telephone_number": "812-336-6008",
            "fax_number": "812-339-6947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "RICARDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01062063A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "200818170",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD INDIVIDUAL",
            "identifier": "P00400660",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID INDIVIDUAL",
            "identifier": "200818170A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "250940",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP",
            "identifier": "517966",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM INDIVIDUAL",
            "identifier": "000000517969",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "250940A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.