Individual provider Active NPI

Maria Elena Villavieja, RN,FNP

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1053462523
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F333668-1 Issued in NY
Practice address
506 Malcolm X Blvd
New Nurses Residence RM 409
New York, NY 10037-1802
Phone
(212) 939-4330
NPI assigned
Jan 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F333668-1 NY Primary

Addresses

Primary practice location

506 Malcolm X Blvd
New Nurses Residence RM 409
New York, NY 10037-1802

Mailing address

49 Jordan Ave
Jersey City, NJ 07306-3215
Phone (201) 779-9075

Other names 1

  • Maria Elena Dalupan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171030001927 NY Practitioner - Nurse Practitioner 9830465269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MKR Medical PCGroup PAC ID 8527291962, 2 clinicians

Practice addresses (Care Compare)

828 Utica Ave
Brooklyn, NY 11203-3409
Phone (718) 303-0851

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F333668-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MKR Medical PC CurrentSince Apr 16, 2024 Accepting new patients

Locations

828 Utica Ave
Brooklyn, NY 11203
Phone (718) 303-0851

545 E Jericho Tpke
Huntington Station, NY 11746
Phone (516) 548-5898

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053462523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 JORDAN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063215",
            "telephone_number": "201-779-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD",
            "address_2": "NEW NURSES RESIDENCE RM 409",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "212-939-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAVIEJA",
        "first_name": "MARIA",
        "middle_name": "ELENA",
        "credential": "RN,FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F333668-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "DALUPAN",
            "middle_name": "ELENA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.