Individual provider Active NPI

Jude Raphael Villaluz Facura, LPN

  • Licensed Practical Nurse
  • Staten Island, NY
National Provider Identifier
1063927267
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
329492 Issued in NY
Practice address
23 Arielle LN
Staten Island, NY 10314-7508
Phone
(914) 837-5052
NPI assigned
Dec 11, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 329492 NY Primary

Addresses

Primary practice location

23 Arielle LN
Staten Island, NY 10314-7508

Mailing address

23 Arielle LN
Staten Island, NY 10314-7508
Phone (914) 837-5052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1063927267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ARIELLE LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147508",
            "telephone_number": "914-837-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ARIELLE LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103147508",
            "telephone_number": "914-837-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACURA",
        "first_name": "JUDE RAPHAEL",
        "middle_name": "VILLALUZ",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-11",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "329492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.