Individual provider Active NPI

Juana Teodora Vargas, MD

  • Emergency Medicine Physician
  • San Jose, CA
National Provider Identifier
1710568266
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A196919 Issued in CA
Practice address
455 Oconnor Dr Ste 250
San Jose, CA 95128-1644
Phone
(408) 283-7666
NPI assigned
Apr 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 A196919 CA Primary

Addresses

Primary practice location

455 Oconnor Dr Ste 250
San Jose, CA 95128-1644

Mailing address

455 Oconnor Dr Ste 250
San Jose, CA 95128-1644
Phone (408) 283-7666

Other practice location 1

North Shore University Hospital
300 Community Drive
Manhasset, NY 11030
Phone (516) 562-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240716001715 CA Practitioner - Emergency Medicine 0244775146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Hofstra North Shore - Lij School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 Pasteur Dr
Palo Alto, CA 94304-2206

3538 Junction Blvd
Apt 3B
Corona, NY 11368-1775

500 Pasteur Dr
Palo Alto, CA 94304-1048

870 Volkman Rd
Evansville, IN 47725-9366

Hospital & facility affiliations

  • El Camino Health Hospital, Mountain View, CA, CCN 050308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A196919CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Network, LLC Past Accepting new patients

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 3

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": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1710568266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR STE 250",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281644",
            "telephone_number": "408-283-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR STE 250",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281644",
            "telephone_number": "408-283-7666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "North Shore University Hospital",
            "address_2": "300 Community Drive",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "11030",
            "country_code": "US",
            "telephone_number": "516-562-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "JUANA",
        "middle_name": "TEODORA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A196919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.