VIDA HEALTH WELLNESS, PLLC
NPI 1720851413
Nurse Practitioner - Psychiatric/Mental Health in Chicago, IL
About Vida Health Wellness, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VIDA HEALTH WELLNESS, PLLC (NPI 1720851413) is a healthcare organization registered as a psychiatric/mental health in Chicago, Illinois and active in the NPI registry since November 2023. The organization holds a CLIA Waiver certificate valid through June 6, 2028 and lists Virginia Bahena, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vida Health Wellness, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Vida Health Wellness, PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 14D2305917
Vida Health Wellness, PLLC · Chicago, ILFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Vida Health Wellness, PLLC's NPI number?
The NPI number for Vida Health Wellness, PLLC is 1720851413. It was assigned to this organization in the NPPES registry on November 3, 2023.
Where is Vida Health Wellness, PLLC located?
Vida Health Wellness, PLLC is located at 5747 W Fullerton Ave, Chicago, IL 60639. The listed phone number is (773) 413-7264.
What is Vida Health Wellness, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Vida Health Wellness, PLLC enrolled in Medicare?
Yes. Vida Health Wellness, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Vida Health Wellness, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Vida Health Wellness, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Vida Health Wellness, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 14D2305917) is associated with this NPI, valid through June 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Vida Health Wellness, PLLC was last updated on June 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Vida Health Wellness, Pllc · NPI 1720851413
Psychiatric/Mental Health organization in Chicago, Illinois. Organization record, active in the CMS NPPES registry since November 3, 2023.
## Identity
- **NPI:** 1720851413 (Entity type: Organization)
- **Enumerated:** November 3, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Virginia Bahena, OWNER
## Practice location
- **Address:** 5747 W FULLERTON AVE, Chicago, IL 60639-2353
- **Phone:** (773) 413-7264
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 28, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1720851413) · Data from the CMS NPPES public registry.