Individual provider Active NPI

Dennis Leonard Vargo, M.D

  • Clinical Pharmacology Physician
  • Boston, MA
National Provider Identifier
1770869604
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pharmacology PhysicianTaxonomy code 208U00000X
License
01036936A Issued in IN
Practice address
108 Fulton St
Apartment 2
Boston, MA 02109-1422
Phone
(617) 528-8988
Fax
(617) 995-4827
NPI assigned
Oct 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01036936A IN
Clinical Pharmacology Physician 208U00000X 01036936A IN Primary

Addresses

Primary practice location

108 Fulton St
Apartment 2
Boston, MA 02109-1422

Mailing address

108 Fulton St
Apartment 2
Boston, MA 02109-1422
Phone (617) 528-8988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01036936AINMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1770869604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 FULTON ST",
            "address_2": "APARTMENT 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091422",
            "telephone_number": "617-528-8988",
            "fax_number": "617-995-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 FULTON ST",
            "address_2": "APARTMENT 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091422",
            "telephone_number": "617-528-8988",
            "fax_number": "617-995-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGO",
        "first_name": "DENNIS",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-24",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01036936A",
            "primary": false
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "IN",
            "license": "01036936A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.