Individual provider Active NPI

Doris Vega Villavicencio, MPH,OTR/L

  • Occupational Therapist
  • Bayamon, PR
National Provider Identifier
1164494472
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
422 Issued in PR
Practice address
SS3 Calle 35
Santa Juanita
Bayamon, PR 00956-4748
Phone
(787) 785-9683
Fax
(787) 785-9683
NPI assigned
Feb 2, 2006
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 422 PR Primary

Addresses

Primary practice location

SS3 Calle 35
Santa Juanita
Bayamon, PR 00956-4748

Mailing address

SS3 Calle 35
Santa Juanita
Bayamon, PR 00956-4748
Phone (787) 785-9683

Other identifiers 2

IdentifierTypeStateIssuer
890461OtherPRMEDICARE Y MUCHO MAS
6605720151OtherPRMCS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
422PRMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Feb 5, 2024 Accepting new patients
Legacy Healthcare Services, Inc Occupational Therapist CurrentSince Feb 5, 2024 Accepting new patients
Hector J Guerra Occupational Therapist Past Accepting new patients
OT Clinical Group Corp Occupational Therapist PastSince Jan 1, 1990 Accepting new patients
New Health Med Group Inc Occupational Therapist Past Accepting new patients

Locations

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1164494472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SS3 CALLE 35",
            "address_2": "SANTA JUANITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009564748",
            "telephone_number": "787-785-9683",
            "fax_number": "787-785-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SS3 CALLE 35",
            "address_2": "SANTA JUANITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009564748",
            "telephone_number": "787-785-9683",
            "fax_number": "787-785-9683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA VILLAVICENCIO",
        "first_name": "DORIS",
        "name_prefix": "Mrs.",
        "credential": "MPH,OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PR",
            "license": "422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE Y MUCHO MAS",
            "identifier": "890461",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCS",
            "identifier": "6605720151",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.