Individual provider Active NPI

Diego Cole Villacis, M.D.

  • Orthopaedic Surgery Physician
  • Summit, WI
National Provider Identifier
1124399449
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
75491 Issued in WI
Practice address
36500 Aurora Dr
Summit, WI 53066-4899
Phone
(262) 434-1000
Fax
(262) 434-5050
NPI assigned
Jan 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036139529 IL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 036139529 IL
Orthopaedic Surgery Physician 207X00000X 75491 WI Primary

Addresses

Primary practice location

36500 Aurora Dr
Summit, WI 53066-4899

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

920 Milwaukee Ave
Lincolnshire, IL 60069-3839
Phone (847) 866-7846

Other identifiers 1

IdentifierTypeStateIssuer
100174818MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dvillacis312668@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 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
I20160815000275 IL Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8224322276 Reassigns benefits to 1 organization
I20210730003215 WI Practitioner - Orthopedic Surgery 8224322276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

W180N11070 River LN
Germantown, WI 53022-3109
Phone (262) 532-9700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)79
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036139529ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Advanced Healthcare, Inc. Orthopaedic Surgery CurrentSince Sep 1, 2021 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Sep 1, 2021 Accepting new patients
Dupage Medical Group LTD CurrentSince May 11, 2020 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 16, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 16, 2021 Accepting new patients
Dupage Medical Group LTD CurrentSince May 11, 2020 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

W180N11070 River Ln
Germantown, WI 53022
Phone (262) 532-9700

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

W231N1440 Corporate Ct
Waukesha, WI 53186
Phone (262) 896-6000

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1124399449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36500 AURORA DR",
            "city": "SUMMIT",
            "state": "WI",
            "postal_code": "530664899",
            "telephone_number": "262-434-1000",
            "fax_number": "262-434-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Lincolnshire",
            "state": "IL",
            "postal_code": "600693839",
            "country_code": "US",
            "telephone_number": "847-866-7846",
            "fax_number": "224-251-4567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLACIS",
        "first_name": "DIEGO",
        "middle_name": "COLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036139529",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036139529",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "75491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100174818",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dvillacis312668@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "36500 Aurora Dr",
            "city": "Summit",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530664899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "36500 Aurora Dr",
            "city": "Summit",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530664899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Summit, WI

Sources for this page

Verify at the official NPI Registry.