Individual provider Active NPI

Vanessa Lujan, PA-C

  • Internal Medicine Physician
  • Edinburg, TX
National Provider Identifier
1790415115
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
PA16680 Issued in TX
Practice address
1201 W University Dr
Edinburg, TX 78539-2909
Phone
(956) 665-7049
NPI assigned
Jun 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X PA16680 TX Primary

Addresses

Primary practice location

1201 W University Dr
Edinburg, TX 78539-2909

Mailing address

1201 W University Dr
Edinburg, TX 78539-2909
Phone (956) 665-7049

Other names 1

  • Vanessa Cavazos Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231121003754 TX Practitioner - Physician Assistant 8022466515 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16680TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Valley Adult Specialists PA Internal Medicine PastSince Oct 12, 2022 Accepting new patients

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": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1790415115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W UNIVERSITY DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785392909",
            "telephone_number": "956-665-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W UNIVERSITY DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785392909",
            "telephone_number": "956-665-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUJAN",
        "first_name": "VANESSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "PA16680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "CAVAZOS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.