Individual provider Active NPI

Neil Edward Villanueva, P.T.

  • Physical Therapist
  • Pasadena, CA
National Provider Identifier
1114018504
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29456 Issued in CA
Practice address
642 E Walnut St
Pasadena, CA 91101-1612
Phone
(310) 351-2809
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 29456 CA Primary

Addresses

Primary practice location

642 E Walnut St
Pasadena, CA 91101-1612

Mailing address

642 E Walnut St
Pasadena, CA 91101-1612
Phone (310) 351-2809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080807000589 CA Practitioner - Physical Therapist in Private Practice 6507930617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rodney K Shorey Physical Therapy Services IncGroup PAC ID 3577561927, 3 clinicians

Practice addresses (Care Compare)

22151 Clarendon St
Woodland Hills, CA 91367-6308
Phone (818) 884-4810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29456CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rodney K. Shorey Physical Therapy Services, Inc. Physical Therapist CurrentSince Apr 14, 2008 Accepting new patients

Locations

22151 Clarendon St
Woodland Hls, CA 91367
Phone (818) 884-4810

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1114018504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 E WALNUT ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011612",
            "telephone_number": "310-351-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 E WALNUT ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011612",
            "telephone_number": "310-351-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "NEIL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.