Organization Active NPI

Michael E Villano MD LLC

  • Facial Plastic Surgery Physician
  • Bend, OR
National Provider Identifier
1124202346
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
Legal business name
MICHAEL E VILLANO MD LLC
Practice address
431 NE Revere Ave
110
Bend, OR 97701-4189
Phone
(541) 312-1145
Fax
(541) 312-8816
NPI assigned
Dec 24, 2007
Last updated
Mar 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Authorized official

Name
Michael E Villano, M.D.NPI 1023069481
Title
Owner
Phone
(541) 312-1145

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X NU Primary

Addresses

Primary practice location

431 NE Revere Ave
110
Bend, OR 97701-4189

Mailing address

431 NE Revere Ave Ste 110
Bend, OR 97701-4189
Phone (541) 312-1145

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150429001948 OR Part B Supplier - Clinic/Group Practice 4082656236 Receives reassigned benefits from 1 practitioner
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

431 NE Revere Ave
Ste 100
Bend, OR 97701
Phone (541) 312-1145

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1124202346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 NE REVERE AVE STE 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014189",
            "telephone_number": "541-312-1145",
            "fax_number": "541-312-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 NE REVERE AVE",
            "address_2": "110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014189",
            "telephone_number": "541-312-1145",
            "fax_number": "541-312-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E VILLANO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "VILLANO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-312-1145",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.