Individual provider Active NPI

Valentina Villegas, PA-C

  • Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1164201422
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA117888 Issued in FL
Practice address
400 Celebration PL Ste A360
Kissimmee, FL 34747-4970
Phone
(407) 975-0209
NPI assigned
Sep 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA117888 FL Primary

Addresses

Primary practice location

400 Celebration PL Ste A360
Kissimmee, FL 34747-4970

Mailing address

1117 Sandestin Way
Orlando, FL 32824-5211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231023001166 FL Practitioner - Physician Assistant 0244686517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairbanks Partners LLCGroup PAC ID 8820303621, 37 clinicians

Practice addresses (Care Compare)

12323 W Colonial Dr
Suite 220
Winter Arden, FL 34787-4179
Phone (407) 975-0200

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 975-0200

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA117888FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairbanks Partners LLC CurrentSince Sep 28, 2023 Accepting new patients
Orlando Neurosurgery, P.a. Past Accepting new patients

Locations

400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000

400 Celebration Pl
Ste A360
Kissimmee, FL 34747
Phone (407) 303-4829

265 E Rollins St
Ste 12000
Orlando, FL 32804

1605 W Fairbanks Ave
Winter Park, FL 32789
Phone (407) 845-8356

Networks

  • Freedom Health HMO Network

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.

Hospital & facility affiliations 3

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": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1164201422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 SANDESTIN WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328245211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL STE A360",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-975-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLEGAS",
        "first_name": "VALENTINA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA117888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.