Individual provider Active NPI

George L. Vega, MD

  • Diagnostic Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1760567762
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME51364 Issued in FL
Practice address
4933 University Blvd W
Jacksonville, FL 32216-5935
Phone
(904) 733-7800
Fax
(904) 419-4888
NPI assigned
Oct 26, 2006
Last updated
Feb 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME51364 FL Primary

Addresses

Primary practice location

4933 University Blvd W
Jacksonville, FL 32216-5935

Mailing address

400 E Bay St Ste 606
Jacksonville, FL 32202-2948
Phone (904) 556-3991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160513002024 GA Practitioner - Diagnostic Radiology 6305821174

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summerlin Imaging Center LLC Diagnostic Radiology CurrentSince Dec 1, 2023 Accepting new patients
Imaging Center of West Palm Beach LLC CurrentSince Apr 22, 2021 Accepting new patients
Summerlin Imaging Center LLC Diagnostic Radiology CurrentSince Dec 1, 2023 Accepting new patients
Elite Radiology of Georgia, LLC Diagnostic Radiology CurrentSince Mar 2, 2016 Accepting new patients
Imaging Center of West Palm Beach LLC CurrentSince Apr 22, 2021 Accepting new patients
Coastline Imaging LLC Diagnostic Radiology CurrentSince May 1, 2026 Accepting new patients
Presgar Imaging of Daytona, LLLP CurrentSince Dec 1, 2019 Accepting new patients
Advance Technological Radiology, PA Diagnostic Radiology PastSince Oct 1, 2017 Accepting new patients

Locations

201 Bill France Blvd
Daytona Beach, FL 32114
Phone (386) 254-6800

4800 Ashford Dunwoody Rd
Atlanta, GA 30338
Phone (404) 419-2058

4800 Ashford Dunwoody Rd
Ste 140
Atlanta, GA 30338
Phone (404) 419-2058

1458 Church St
Ste D
Decatur, GA 30030
Phone (404) 419-2058

2623 N Decatur Rd
Decatur, GA 30033

3547 Peachtree Industrial Blvd
Duluth, GA 30096
Phone (312) 929-8662

939 Bob Arnold Blvd
Ste C
Lithia Springs, GA 30122
Phone (404) 946-2885

790 Church St NE
Ste 150
Marietta, GA 30060
Phone (770) 422-4268

1040 Eagles Landing Pkwy
Ste 102
Stockbridge, GA 30281
Phone (404) 419-2058

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1760567762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E BAY ST STE 606",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022948",
            "telephone_number": "904-556-3991",
            "fax_number": "904-356-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4933 UNIVERSITY BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165935",
            "telephone_number": "904-733-7800",
            "fax_number": "904-419-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "GEORGE",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME51364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.