Michael R Villanueva, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0974 Issued in OR

Practice address

837 Alder Creek Dr
Medford, OR 97504-8911

Phone

(541) 608-3878

Fax

(541) 608-3880

NPI assigned

Aug 30, 2006

Last updated

Jun 22, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Oregon Neuropsychological Clinic LLCGroup PAC ID 8729050877, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.74 of 100Reported as group

Quality

81.47

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern Oregon Neuropsychological Clinic LLC

  • Clinical Neuropsychologist
  • Medford, OR
  • NPI 1588726939
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1063522860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 ALDER CREEK DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048911",
            "telephone_number": "541-608-3878",
            "fax_number": "541-608-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 ALDER CREEK DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048911",
            "telephone_number": "541-608-3878",
            "fax_number": "541-608-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "0974",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "0974",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042601",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittney Villa
• Laura L Villa, PHARMD
• Mayela Villa
• Carryl Villanueva
• McKenzie Villanueva
• Sophia Yvonne Villarreal
• Rita Vinatieri, SLP
• Suyenne Vinluan, PT, DPT
• Visionworks Inc (Visionworks)
• Vista Pathology Laboratory, LLC

• Clinical Neuropsychologist in Medford, OR
• Providers in Medford, OR by specialty
• Clinical Neuropsychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.