Isaias Rodolfo Vargas Jr., CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NP95011154 Issued in CA

Practice address

16850 Bear Valley Rd
Victorville, CA 92395-5795

Phone

(760) 241-8000

NPI assigned

May 18, 2018

Sex

Male

Sole proprietor

Yes

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.

• Desert Valley Medical Group, Inc.

  • Physical Therapist
  • Victorville, CA
  • NPI 1639117864

  CA

  Medicare reassignment NPD
• Desert Valley Medical Group, Inc

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1952020315
  NPD
• Desert Valley Medical Group, Inc.

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Victorville, CA
  • NPI 1912945114
  NPD

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: isaias.vargasjr.p1@direct.dvmg.nextgenshare.com

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

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1992296545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1786",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917291786",
            "telephone_number": "702-675-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16850 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955795",
            "telephone_number": "760-241-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "ISAIAS",
        "middle_name": "RODOLFO",
        "name_suffix": "Jr.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-18",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP018742",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP95011154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monserrat Vargas Hernandez
• Alberto Vargas
• Alex Vargas
• Genesis Vargas
• Gessaiah Eden Vargas, RN
• Kitzya Vargas
• Marisol Vargas
• Nelson Vasquez Rosa
• Beatriz Vasquez
• Emma Leticia Vasquez

• All providers in Victorville, CA
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.