Organization Active NPI

Vega Alta Radiology, Inc.

  • Radiology Clinic/Center
  • Vega Alta, PR
National Provider Identifier
1801940556
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
02-171 Issued in PR
Legal business name
VEGA ALTA RADIOLOGY, INC.
Practice address
1 Calle Marginal Ste 103
Vega Alta, PR 00692-6797
Phone
(787) 270-0520
Fax
(787) 270-0530
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Authorized official

Name
Dennis E Perez, MDNPI 1932131067
Title
Radiologist / Medical Director
Phone
(787) 270-0520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 02-171 PR Primary

Addresses

Primary practice location

1 Calle Marginal Ste 103
Vega Alta, PR 00692-6797

Mailing address

1 Calle Marginal Ste 103
Vega Alta, PR 00692-6797
Phone (787) 270-0520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160512000617 PR Part B Supplier - Clinic/Group Practice 8123317294 Receives reassigned benefits from 1 practitioner
Practice locations: Vega Alta, PR

National Provider Directory

National Provider Directory

Locations

1 Calle Marginal
Ste 103
Vega Alta, PR 00692
Phone (787) 270-0520

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1801940556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CALLE MARGINAL STE 103",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006926797",
            "telephone_number": "787-270-0520",
            "fax_number": "787-270-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CALLE MARGINAL STE 103",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006926797",
            "telephone_number": "787-270-0520",
            "fax_number": "787-270-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEGA ALTA RADIOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "RADIOLOGIST / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "787-270-0520",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "PR",
            "license": "02-171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Alta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.