Individual provider Active NPI

Theresa M Vergara, M.D.

  • Pediatric Critical Care Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1780677690
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
9171 Issued in NV
Practice address
3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone
(888) 350-2911
Fax
(702) 369-5827
NPI assigned
Aug 25, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9171 NV
Pediatric Critical Care Medicine Physician 2080P0203X 9171 NV Primary

Addresses

Primary practice location

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317

Mailing address

3006 S Maryland Pkwy
505
Las Vegas, NV 89109-2218
Phone (702) 697-0082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20180227002214 NV Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7315078128

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780677690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 S MARYLAND PKWY",
            "address_2": "505",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092218",
            "telephone_number": "702-697-0082",
            "fax_number": "702-369-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 S MARYLAND PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891092317",
            "telephone_number": "888-350-2911",
            "fax_number": "702-369-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "9171",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NV",
            "license": "9171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.