Individual provider Active NPI

Jason M Vega, PT

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1972521904
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5601 Issued in SC
Practice address
1910 Blanding St
Columbia, SC 29201-3520
Phone
(803) 256-4107
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2368 MS
Physical Therapist 225100000X 5601 SC Primary

Addresses

Primary practice location

1910 Blanding St
Columbia, SC 29201-3520

Mailing address

1910 Blanding St
Columbia, SC 29201-3520
Phone (803) 256-4107

Other identifiers 2

IdentifierTypeStateIssuer
P00346935OtherMSRAILROAD
03274724MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080925000363 SC Practitioner - Physical Therapist in Private Practice 1850396375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1910 Blanding St
Columbia, SC 29201-3520
Phone (803) 256-4107

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601SCMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midlands Orthopaedics and Neurosurgery, PA CurrentSince Jun 15, 2017 Accepting new patients
Midlands Orthopaedics and Neurosurgery PA CurrentSince Jun 15, 2017 Accepting new patients
Midlands Orthopaedics and Neurosurgery, PA Past Accepting new patients
Northlake Physical Therapy and Rehabilitation Services, Inc. Physical Therapist Past Accepting new patients

Locations

1910 Blanding St
Columbia, SC 29201
Phone (803) 253-6721

1013 Lake Murray Blvd
Irmo, SC 29063
Phone (803) 732-5887

109 Park Place Ct
Lexington, SC 29072
Phone (803) 933-6784

Interoperability endpoints

  • Direct secure messaging: jason.vega.1@5499.direct.athenahealth.com

Organizations & group practices 4

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972521904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 BLANDING ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013520",
            "telephone_number": "803-256-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 BLANDING ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013520",
            "telephone_number": "803-256-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "JASON",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT2368",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "5601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00346935",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03274724",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.