Physician Compare National (NPI:1336146679)

HEALTHCARE PROVIDER: SERGIO R VEGA M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1336146679
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294767257
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101022000741
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VEGA
	Individual professional last name
Provider First Name	SERGIO
	Individual professional first name
Provider Middle Name	RENE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	YALE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1500N DIXIE HWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 206
	Group Practice or individual's line 2 address
City	WEST PALM BEACH
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	334012716
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100287
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GOOD SAMARITAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100288
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST MARY'S MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y