Individual provider Active NPI

Daniel J Reyes-Villa, M.D.

  • Family Medicine Physician
  • San Jose, CA
National Provider Identifier
1013136563
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A101639 Issued in CA
Practice address
841 Blossom Hill Rd Ste 215
San Jose, CA 95123-2704
Phone
(408) 629-7095
Fax
(408) 818-2352
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A101639 CA Primary

Addresses

Primary practice location

841 Blossom Hill Rd Ste 215
San Jose, CA 95123-2704

Mailing address

841 Blossom Hill Rd Ste 215
San Jose, CA 95123-2704
Phone (408) 629-7095

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081103000418 CA Practitioner - Family Practice 3173682374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

841 Blossom Hill Rd
Suite 215
San Jose, CA 95123-2704

841 Blossom Hill Rd
Suite 215
San Jose, CA 95123-2708
Phone (408) 629-7095

Hospital & facility affiliations

  • Ace Home Health Care & Hospice, Inc Home health agency, Orinda, CA, CCN 059461

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A101639CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seres Prime Healthcare CurrentSince Dec 2, 2019 Accepting new patients
Sandra Torres MD, Medical Corporation PastSince Mar 21, 2017 Accepting new patients
County of Santa Clara Past Accepting new patients

Locations

841 Blossom Hill Rd
Ste 215
San Jose, CA 95123
Phone (408) 629-7025

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8937/brand/1/csg/1/fhir/r4
  • Direct secure messaging: daniel.reyes-villa@1956168269828.direct.elationemr.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1013136563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 BLOSSOM HILL RD STE 215",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232704",
            "telephone_number": "408-629-7095",
            "fax_number": "408-818-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 BLOSSOM HILL RD STE 215",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232704",
            "telephone_number": "408-629-7095",
            "fax_number": "408-818-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES-VILLA",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A101639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.