Active NPI
Jorge Luis Vega Flores
- Speech-Language Pathologist
- Melville, NY
National Provider Identifier
1942585757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 021427
- Practice address
- 538 Broadhollow Road Suite 202
Melville, NY 11747 - Phone
- (631) 385-7780
- Fax
- (631) 385-7795
- NPI assigned
- Oct 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 021427 | NY | Primary |
Addresses
Primary practice location
538 Broadhollow Road Suite 202
Melville, NY 11747
Mailing address
440 Old Nichols Road
Hauppauge, NY 11788-5013
Phone (631) 220-0704
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021427 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318464000000",
"number": "1942585757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 OLD NICHOLS ROAD",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117885013",
"telephone_number": "631-220-0704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "538 BROADHOLLOW ROAD SUITE 202",
"city": "MELVILLE",
"state": "NY",
"postal_code": "11747",
"telephone_number": "631-385-7780",
"fax_number": "631-385-7795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEGA FLORES",
"first_name": "JORGE",
"middle_name": "LUIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-13",
"last_updated": "2011-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "021427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.