Sergio Banuelos Villegas, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G65363 Issued in CA

Practice address

1701 E Cesar Chavez Ave
Suite 402
Los Angeles, CA 90033-2464

Phone

(323) 317-9200

Fax

(323) 317-9206

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Family Practice

Education

University of California, Davis School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Care Specialists Medical CorporationGroup PAC ID 6709834112, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health White Memorial Hospital, Los Angeles, CA, CCN 050103

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: sergio.villegas.3@24668.direct.athenahealth.com

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.

• Family Care Specialists Medical Corporation

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1649223777
  Medicare reassignment Care Compare group NPD
• Altais Medical Group - Riverside, Inc.

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1518629575
  Medicare reassignment NPD
• Family Care Specialists Medical Corporation

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1982657029
  NPD
• White Memorial Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1215927470
  NPD (past)

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

• White Memorial Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1215927470
  Care Compare affiliation

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1063463339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5823 YORK BLVD STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900422634",
            "telephone_number": "323-255-5643",
            "fax_number": "323-254-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E CESAR CHAVEZ AVE",
            "address_2": "SUITE 402",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332464",
            "telephone_number": "323-317-9200",
            "fax_number": "323-317-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLEGAS",
        "first_name": "SERGIO",
        "middle_name": "BANUELOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G65363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G653630",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080052215",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G653630",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia F. Villegas, DO
• Rebecca Elizabeth Villegas
• Ronald Michael Depanes Villegas
• Rosary Villegas, A.S.W.
• Rosio Villegas, FNP
• Vanessa Villegas
• Virginia Villegas, RNC, NP
• Amelia Villero, P.T.
• Jonathan Villicana, PSYD
• Maria Fe Bellen Villosis, M.D.

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.