NPIMap

Individual provider Active NPI

Raymond A Villaverde, P.A.

  • Surgical Physician Assistant
  • Capitola, CA
National Provider Identifier
1033118237
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA21732 Issued in CA
Practice address
4140 Jade St
Suite 100
Capitola, CA 95010-3956
Phone
(831) 475-4344
Fax
(831) 475-4344
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Clinical Nurse Specialist 364SM0705X 085-001011 IL
Surgical Physician Assistant 363AS0400X PA21732 CA Primary

Addresses

Primary practice location

4140 Jade St
Suite 100
Capitola, CA 95010-3956

Mailing address

4140 Jade St
Suite 100
Capitola, CA 95010-3956
Phone (831) 475-4344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110902000105 CA Practitioner - Physician Assistant 0749284636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Orthopedics and SpineGroup PAC ID 8224940739, 186 clinicians

Practice addresses (Care Compare)

1066 S Green Valley Rd
Watsonville, CA 95076-4163
Phone (831) 722-1444

2405 Shadelands Dr
Walnut Creek, CA 94598-2444
Phone (925) 939-8585

340 Dardanelli LN
Suite 10
Los Gatos, CA 95032-1418
Phone (408) 412-8100

Hospital & facility affiliations

  • Dominican Hospital Hospital, Santa Cruz, CA, CCN 050242
  • El Camino Health Hospital, Mountain View, CA, CCN 050308
  • Watsonville Community Hospital Hospital, Watsonville, CA, CCN 050194

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA21732CAMDSurgical Physician Assistant
085-001011ILMDMedical-Surgical Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Orthopedics & Spine CurrentSince Jan 1, 2022 Accepting new patients
Orthonorcal Inc CurrentSince Oct 21, 2012 Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients

Locations

4140 Jade St
Ste 100
Capitola, CA 95010
Phone (831) 475-4024

340 Dardanelli Ln
Ste 10
Los Gatos, CA 95032
Phone (408) 412-8100

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: raymond.villaverde.p1@direct.orthonorcal.nextgenshare.com
  • Direct secure messaging: raymond.villaverde.p2@direct.muirortho.nextgenshare.com

Organizations & group practices 5

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 5

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1033118237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 JADE ST",
            "address_2": "SUITE 100",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950103956",
            "telephone_number": "831-475-4344",
            "fax_number": "831-475-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 JADE ST",
            "address_2": "SUITE 100",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950103956",
            "telephone_number": "831-475-4344",
            "fax_number": "831-475-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAVERDE",
        "first_name": "RAYMOND",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "IL",
            "license": "085-001011",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA21732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitola, CA

Sources for this page

Verify at the official NPI Registry.