Individual provider Active NPI

Robert C Villare, MD

  • Vascular Surgery Physician
  • Woodbury, NJ
National Provider Identifier
1124012273
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD039406L Issued in PA
Practice address
113 Westwood Hill
Woodbury, NJ 08096-1178
Phone
(856) 848-4131
Fax
(856) 848-4131
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Aerospace Medicine Physician 2083A0100X MD039406L PA
Surgery Physician 208600000X 25MA04703400 NJ
Surgery Physician 208600000X C10005653 DE
Surgery Physician 208600000X MD039406L PA
Vascular Surgery Physician 2086S0129X 25MA04703400 NJ
Vascular Surgery Physician 2086S0129X C10005653 DE
Vascular Surgery Physician 2086S0129X MD039406L PA Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 25MA04703400 NJ
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X C10005653 DE
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD039406L PA

Addresses

Primary practice location

113 Westwood Hill
Woodbury, NJ 08096-1178

Mailing address

113 Westwood Hill
Woodbury, NJ 08096-1178
Phone (856) 848-4131

Other identifiers 1

IdentifierTypeStateIssuer
1000002081MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050310000811 NJ Practitioner - General SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular SurgeryPractitioner - Other (Physician) 2264428804 Practice locations: Woodbury, NJ
I20120308000055 PA Practitioner - General SurgeryPractitioner - Undersea and Hyperbaric MedicinePractitioner - Vascular Surgery 2264428804 Practice locations: Lebanon, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD039406LPAMDSurgery Physician
C10005653DEMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Valley Physicians & Surgeons PastSince Nov 19, 2003 Accepting new patients

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": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1124012273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 WESTWOOD HILL",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961178",
            "telephone_number": "856-848-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WESTWOOD HILL",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961178",
            "telephone_number": "856-848-4131",
            "fax_number": "856-848-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARE",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "PA",
            "license": "MD039406L",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA04703400",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DE",
            "license": "C10005653",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD039406L",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA04703400",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "DE",
            "license": "C10005653",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD039406L",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "25MA04703400",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "DE",
            "license": "C10005653",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD039406L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000002081",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.