Individual provider Active NPI

Luis H Vigil, M.D.

  • Internal Medicine Physician
  • Ada, OK
National Provider Identifier
1750302873
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101238880 Issued in VA
Practice address
430 N Monte Vista St
Ada, OK 74820-4610
Phone
(580) 332-8846
Fax
(580) 421-1208
NPI assigned
Jul 22, 2006
Last updated
Jun 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101238880 VA Primary

Addresses

Primary practice location

430 N Monte Vista St
Ada, OK 74820-4610

Mailing address

205 Benton Dr Apt 9111
Allen, TX 75013-1163
Phone (214) 205-2223

Other identifiers 2

IdentifierTypeStateIssuer
10416922MedicaidVA
0101238880OtherVAVIRGINIA MEDICAL LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20140425000725 OK Practitioner - Internal MedicinePractitioner - Hospitalist 2567565336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

430 N Monte Vista St
Ada, OK 74820-4610
Phone (580) 332-2323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101238880VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities Internal Medicine CurrentSince Feb 16, 2014 Accepting new patients
Mercy Hospital Tishomingo, Inc. CurrentSince Sep 18, 2023 Accepting new patients
Mercy Hospital Tishomingo, Inc CurrentSince Sep 18, 2023 Accepting new patients
Mercy Hospital Ada, Inc Past Accepting new patients

Locations

430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

1000 S Byrd St
Tishomingo, OK 73460
Phone (580) 371-2327

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1750302873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BENTON DR APT 9111",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750131163",
            "telephone_number": "214-205-2223",
            "fax_number": "214-324-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204610",
            "telephone_number": "580-332-8846",
            "fax_number": "580-421-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGIL",
        "first_name": "LUIS",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101238880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10416922",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICAL LIC",
            "identifier": "0101238880",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.