DE LA VEGA PEDIATRICS, CORP.
NPI 1790066983
General Practice in Fort Myers, FL
About De La Vega Pediatrics, Corp. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DE LA VEGA PEDIATRICS, CORP. (NPI 1790066983) is a healthcare organization registered as a general practice in Fort Myers, Florida and active in the NPI registry since September 2011. The organization holds a CLIA Waiver certificate valid through September 8, 2028 and lists Tatiana De La Vega, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
De La Vega Pediatrics, Corp. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to De La Vega Pediatrics, Corp., 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 10D2012851
De La Vega Pediatrics · Fort Myers, FLFrequently 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 De La Vega Pediatrics, Corp.'s NPI number?
The NPI number for De La Vega Pediatrics, Corp. is 1790066983. It was assigned to this organization in the NPPES registry on September 1, 2011.
Where is De La Vega Pediatrics, Corp. located?
De La Vega Pediatrics, Corp. is located at 12781 World Plaza Ln Ste 1, Fort Myers, FL 33907. The listed phone number is (239) 277-5877.
What is De La Vega Pediatrics, Corp.'s specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is De La Vega Pediatrics, Corp. enrolled in Medicare?
Yes. De La Vega Pediatrics, Corp. is registered in the Medicare PECOS enrollment system.
When is De La Vega Pediatrics, Corp.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through De La Vega Pediatrics, Corp.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to De La Vega Pediatrics, Corp.. 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 De La Vega Pediatrics, Corp. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D2012851) is associated with this NPI, valid through September 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does De La Vega Pediatrics, Corp. accept?
Health plans from Ambetter Health and Ambetter of Alabama list De La Vega Pediatrics, Corp. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for De La Vega Pediatrics, Corp. was last updated on March 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# De La Vega Pediatrics, Corp. · NPI 1790066983
General Practice organization in Fort Myers, Florida. Organization record, active in the CMS NPPES registry since September 1, 2011.
## Identity
- **NPI:** 1790066983 (Entity type: Organization)
- **Enumerated:** September 1, 2011
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Organization subpart:** No
- **Authorized official:** Tatiana De La Vega, OFFICE MANAGER
## Practice location
- **Address:** 12781 WORLD PLAZA LN STE 1, Fort Myers, FL 33907-4078
- **Phone:** (239) 277-5877 · **Fax:** (239) 277-1354
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (General Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 25, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1790066983) · Data from the CMS NPPES public registry.