Individual provider Active NPI

Tatiana Villa, FNP

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1144573908
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F339608-1 Issued in NY
Practice address
1065 Southern Blvd
Bronx, NY 10459-2417
Phone
(718) 589-2440
Fax
(718) 991-4516
NPI assigned
Oct 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F339608-1 NY Primary
Registered Nurse 163W00000X 653648-1 NY

Addresses

Primary practice location

1065 Southern Blvd
Bronx, NY 10459-2417

Mailing address

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151119002471 NY Practitioner - Nurse Practitioner 0345540571 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
653648-1NYMDRegistered Nurse
F339608-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince Mar 11, 2019 Accepting new patients
Urban Health Plan, Inc. CurrentSince Mar 11, 2019 Accepting new patients
Urban Health Plan, Inc. Current Accepting new patients

Locations

866 E Tremont Ave
Bronx, NY 10460
Phone (347) 284-0595

1764 Westchester Ave
#66
Bronx, NY 10472

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

890 Hunts Point Ave
Bronx, NY 10474
Phone (718) 589-2141

1515 Southern Blvd
Bronx, NY 10460
Phone (718) 589-1600

3209 3rd Ave
Bronx, NY 10451
Phone (347) 284-0203

960 Southern Blvd
Bronx, NY 10459
Phone (347) 331-6572

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

271 E 138th St
Bronx, NY 10454
Phone (347) 407-7120

3712 108th St
Corona, NY 11368
Phone (718) 639-4107

154 W 127th St
New York, NY 10027
Phone (212) 280-0804

Organizations & group practices 3

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": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1144573908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440",
            "fax_number": "718-991-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440",
            "fax_number": "718-991-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "TATIANA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F339608-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "653648-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.