Georgina Laus Villacorta, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95020330 Issued in CA

Practice address

8070 Jurupa Avenue
Riverside, CA 92506

Phone

(155) 499-1933

NPI assigned

Jun 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: georgina.villacorta.1@29786.direct.athenahealth.com

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.

• Hospitalist Medicine Physicians of California, Inc

  • Internal Medicine Physician
  • Apple Valley, CA
  • NPI 1184663965
  Medicare reassignment NPD
• Midwest Post-Acute Care of California PC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1326490871

  CA

  Medicare reassignment NPD
• Mpac SMH of California PC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1821660960

  CA

  Medicare reassignment NPD
• Moreno Valley Community Medical Group

  • Multi-Specialty Clinic/Center
  • Moreno Valley, CA
  • NPI 1437595873
  Medicare reassignment

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1174192512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 JURUPA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062234",
            "telephone_number": "951-808-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8070 JURUPA AVENUE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "155-499-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLACORTA",
        "first_name": "GEORGINA",
        "middle_name": "LAUS",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "606009",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Villa
• Maria Villa
• Noemi G Villa
• Pedro Villa, B.C.B.A.
• Rosemarie Villa
• Village Dental Care
• Ivette Villagomez, NONE
• Vanessa J Villagomez
• Deenise Cassey Villagran
• Rosa Villagran

• Family Nurse Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.