Active NPI
Robert C Villare, MD
- Vascular Surgery Physician
- Woodbury, NJ
National Provider Identifier
1124012273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- MD039406L
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000002081 | Medicaid | DE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050310000811 | NJ | Practitioner - General Surgery | 2264428804 | Practice locations: Woodbury, NJ |
| I20120308000055 | PA | Practitioner - General Surgery | 2264428804 | Practice locations: Lebanon, PA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD039406L | PA | MD | Surgery Physician |
| C10005653 | DE | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware Valley Physicians & Surgeons | Past | 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.
-
- Specialist
- Paulsboro, NJ
- NPI 1659446169
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.