Individual provider Active NPI

Vongpheth Luangphaxay McCarthy

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Aurora, CO
National Provider Identifier
1740370188
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
48651 Issued in CO
Practice address
1501 S Potomac St
Aurora, CO 80012-5411
Phone
(303) 306-7783
Fax
(303) 306-7753
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00046618 WA
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 48651 CO Primary

Addresses

Primary practice location

1501 S Potomac St
Aurora, CO 80012-5411

Mailing address

PO Box 173862
Denver, CO 80217-3862
Phone (303) 306-7783

Other identifiers 3

IdentifierTypeStateIssuer
8459422MedicaidWA
95002782MedicaidCO
P00835980OtherCORAILROAD PIN

Other names 1

  • Vongpheth Luangphaxay Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20100525000219 CO Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 4183753445 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48651COMDPediatric Emergency Medicine (Emergency Medicine) Physician
MD00046618WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Permanente Medical Group, P.C. Pediatrics CurrentSince Feb 13, 2017 Accepting new patients
Carepoint P.C. CurrentSince Apr 1, 2010 Accepting new patients
HCA Healthone LLC Past Accepting new patients
Good Samaritan Medical Center, LLC Past Accepting new patients
Saint Joseph Hospital, Inc Past Accepting new patients
Catholic Health Iniatives Colorado Past Accepting new patients
HCA Healthone LLC Past Accepting new patients
Children's Hospital Colorado Past Accepting new patients

Locations

13123 E 16th Ave
#B450
Aurora, CO 80045

1501 S Potomac St
Denver, CO 80012
Phone (303) 695-2604

4567 E 9th Ave
Denver, CO 80220
Phone (303) 302-2121

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

1719 E 19th Ave
Denver, CO 80218
Phone (303) 839-6000

9141 Grant St
Ste B40
Thornton, CO 80229
Phone (303) 453-2554

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1740370188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173862",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173862",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S POTOMAC ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800125411",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "VONGPHETH",
        "middle_name": "LUANGPHAXAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00046618",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "CO",
            "license": "48651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8459422",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95002782",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PIN",
            "identifier": "P00835980",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VONGPHETH",
            "last_name": "LUANGPHAXAY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.