NPIMap

Individual provider Active NPI

Juan Camilo Vanegas, MD

  • Emergency Medicine Physician
  • Portland, OR
National Provider Identifier
1699238535
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD210500 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd # L579
Portland, OR 97239-3098
Phone
(503) 494-8211
NPI assigned
Apr 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD210500 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd # L579
Portland, OR 97239-3098

Mailing address

3181 SW Sam Jackson Park Rd # L579
Portland, OR 97239-3098
Phone (503) 494-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220812002708 OR Practitioner - Emergency Medicine 1951634609 Reassigns benefits to 2 organizations
I20221129001300 TX Practitioner - Emergency Medicine 1951634609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Emergency Physicians PLLCGroup PAC ID 4880048560, 94 clinicians

Practice addresses (Care Compare)

2830 Calder St
Beaumont, TX 77702-1809
Phone (409) 892-7171

Hospital & facility affiliations

  • Christus Southeast Texas- St Elizabeth Hospital, Beaumont, TX, CCN 450034
  • Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
62.39
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD210500ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Emergency Medicine Associates PA Emergency Medicine CurrentSince Oct 18, 2022 Accepting new patients
Jefferson Emergency Physicians, PLLC Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Jasper Emergency Medicine Associates PA Emergency Medicine CurrentSince Oct 18, 2022 Accepting new patients
Jasper Emergency Physicians, PLLC Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Columbia Lutheran Charities Current Accepting new patients
Columbia Lutheran Charities CurrentSince Aug 4, 2022 Accepting new patients
Southeast Emergency Medicine Associates, PA Emergency Medicine CurrentSince Oct 18, 2022 Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

3181 SW Sam Jackson Park Rd
#L579
Portland, OR 97239
Phone (503) 494-8652

10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355

2830 Calder St
Beaumont, TX 77702
Phone (409) 899-7000

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

8801 9th Ave
Port Arthur, TX 77642
Phone (409) 299-3214

Interoperability endpoints

  • Direct secure messaging: jcamilovanegas108858@direct.ohsu.edu

Organizations & group practices 9

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1699238535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # L579",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # L579",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANEGAS",
        "first_name": "JUAN CAMILO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD210500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.