Individual provider Active NPI

Vanessa Vergara, ARNP

  • Family Nurse Practitioner
  • North Lauderdale, FL
National Provider Identifier
1780127720
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9319705 Issued in FL
Practice address
6971 SW 19TH St
North Lauderdale, FL 33068-4816
Phone
(954) 857-7787
NPI assigned
Nov 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9319705 FL Primary

Addresses

Primary practice location

6971 SW 19TH St
North Lauderdale, FL 33068-4816

Mailing address

12474 Shore View Dr
Firestone, CO 80504-8214
Phone (954) 857-7787

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125000235 FL Practitioner - Nurse Practitioner 1850674276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Miami, LM Miller School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ez Health Medical Group PAGroup PAC ID 7214469816, 34 clinicians

Practice addresses (Care Compare)

1801 NE 123Rd St
Suite 314
North Miami, FL 33181-2883
Phone (385) 327-2541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9319705FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners Colorado, PC Nurse Practitioner CurrentSince Oct 14, 2022 Accepting new patients
Openloop Healthcare Partners California PC Nurse Practitioner CurrentSince Oct 14, 2022 Accepting new patients
Clinica Colorado Current Accepting new patients
Openloop Healthcare Partners California PC Nurse Practitioner CurrentSince Oct 14, 2022 Accepting new patients
Ez Health Medical Group PA CurrentSince Sep 9, 2024 Accepting new patients

Locations

2121 E Coast Hwy
Ste 270
Corona del Mar, CA 92625
Phone (949) 694-4937

818 W 7th St
Los Angeles, CA 90017
Phone (949) 694-4937

72650 Fred Waring Dr
Ste 106
Palm Desert, CA 92260
Phone (760) 230-9990

71935 Highway 111
Rancho Mirage, CA 92270
Phone (949) 694-4937

1600 Broadway
Ste 1600
Denver, CO 80202
Phone (970) 592-8970

1801 NE 123rd St
Ste 314
North Miami, FL 33181
Phone (239) 380-8220

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

4500 Mercantile Plaza Dr
Ste 300
Ft Worth, TX 76137
Phone (469) 688-9501

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19093/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/24370/brand/1/csg/1/fhir/r4
  • Direct secure messaging: vanessa.vergara.1@24370.direct.athenahealth.com

Organizations & group practices 5

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": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1780127720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12474 SHORE VIEW DR",
            "city": "FIRESTONE",
            "state": "CO",
            "postal_code": "805048214",
            "telephone_number": "954-857-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6971 SW 19TH ST",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "330684816",
            "telephone_number": "954-857-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "VANESSA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9319705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.