Individual provider Active NPI

Edisson 'Xavier' Vega-Cordova, M.D.

  • Otolaryngology Physician
  • Hialeah, FL
National Provider Identifier
1750574190
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME134284 Issued in FL
Practice address
7100 W 20TH Ave Ste 608
Hialeah, FL 33016-1824
Phone
(305) 557-4016
Fax
(305) 828-0670
NPI assigned
Aug 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 125-053608 IL
Otolaryngology Physician 207Y00000X 45642 AZ
Otolaryngology Physician 207Y00000X ME134284 FL Primary

Addresses

Primary practice location

7100 W 20TH Ave Ste 608
Hialeah, FL 33016-1824

Mailing address

15280 NW 79TH CT Ste 200
Miami Lakes, FL 33016-5873
Phone (305) 558-3724

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edissonxaviervega-cordova@sfa.allscriptsdirect.net South Florida ENT Associates, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180111000744 FL Practitioner - Otolaryngology 6901062991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida ENT Associates IncGroup PAC ID 4587556923, 156 clinicians

Practice addresses (Care Compare)

7100 W 20TH Ave
Suite 608
Hialeah, FL 33016-1824
Phone (305) 557-4016

Merit-based Incentive Payment System (MIPS)

Final score
70.4 of 100Reported as group
Quality
47.82
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME134284FLMDOtolaryngology Physician
125-053608ILMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida ENT Associates, Inc. Otolaryngology CurrentSince Feb 1, 2018 Accepting new patients
Florida ENT Associates, Inc. Otolaryngology PastSince Jan 17, 2022 Accepting new patients

Locations

7100 W 20th Ave
Ste 404
Hialeah, FL 33016
Phone (305) 362-8180

7100 W 20th Ave
Ste 608
Hialeah, FL 33016
Phone (305) 557-4016

8940 N Kendall Dr
Ste 504E
Miami, FL 33176
Phone (305) 595-6200

15280 NW 79th Ct
Ste 200
Miami Lakes, FL 33016

8181 NW 154th St
Ste 200
Miami Lakes, FL 33016
Phone (225) 298-3537

Interoperability endpoints

  • Direct secure messaging: edissonxaviervega-cordova@sfa.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1750574190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT STE 200",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165873",
            "telephone_number": "305-558-3724",
            "fax_number": "786-907-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 W 20TH AVE STE 608",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161824",
            "telephone_number": "305-557-4016",
            "fax_number": "305-828-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA-CORDOVA",
        "first_name": "EDISSON 'XAVIER'",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "125-053608",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "45642",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME134284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edissonxaviervega-cordova@sfa.allscriptsdirect.net",
            "affiliation": "Y",
            "affiliationName": "South Florida ENT Associates, Inc.",
            "address_1": "7100 W 20th Ave Ste 608",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330161824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.