NPIMap

Individual provider Active NPI

Ian Villanueva, DNP, FNP-BC

  • Family Nurse Practitioner
  • Boulder, CO
National Provider Identifier
1033706429
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0996133-NP Issued in CO
Practice address
1900 Wardenburg Drive
Boulder, CO 80309-1508
Phone
(314) 499-8625
NPI assigned
Dec 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0996133-NP CO Primary

Addresses

Primary practice location

1900 Wardenburg Drive
Boulder, CO 80309-1508

Mailing address

1312 17TH St # 991
Denver, CO 80202-1508
Phone (314) 499-8625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20210309001311 CO Practitioner - Nurse Practitioner 7315353851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Nephrology and Metabolic Bone Disease, P.C.Group PAC ID 2264428622, 33 clinicians

Practice addresses (Care Compare)

5265 Vance St
Suite 200
Arvada, CO 80002-3714
Phone (303) 232-3366

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.99 of 100Reported as group
Quality
89.64
Promoting interoperability
98
Improvement activities
40
Cost
74.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0996133-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Nephrology & Metabolic Bone Disease, P.C. CurrentSince Mar 8, 2021 Accepting new patients
Tapestry Telehealth PLLC Nurse Practitioner Past Accepting new patients
Western Nephrology & Metabolic Bone Disease, P.C. PastSince Sep 20, 2020 Accepting new patients
Western Nephrology & Metabolic Bone Disease, P.C. Past Accepting new patients

Locations

5265 Vance St
Ste 200
Arvada, CO 80002
Phone (303) 232-3366

355 Union Blvd
Ste 360
Lakewood, CO 80228
Phone (720) 651-9500

4891 Independence St
Ste 120
Wheat Ridge, CO 80033
Phone (303) 232-3366

919 Lehua Ave
Pearl City, HI 96782
Phone (808) 453-1919

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACHACA

Organizations & group practices 4

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1033706429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 17TH ST # 991",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021508",
            "telephone_number": "314-499-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WARDENBURG DRIVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803091508",
            "telephone_number": "314-499-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "IAN",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0996133-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.