Individual provider Active NPI

Rebecca C Villar, PSYD

  • Clinical Neuropsychologist
  • Lake Mary, FL
National Provider Identifier
1174862882
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY8696 Issued in FL
Practice address
1355 S International Pkwy
Ste 2471
Lake Mary, FL 32746-1694
Phone
(407) 906-8843
Fax
(888) 335-7778
NPI assigned
Feb 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY 8696 FL
Clinical Neuropsychologist 103G00000X PY8696 FL Primary

Addresses

Primary practice location

1355 S International Pkwy
Ste 2471
Lake Mary, FL 32746-1694

Mailing address

1355 S International Pkwy
Ste 2471
Lake Mary, FL 32746-1694
Phone (407) 906-8843

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130214000237 FL Practitioner - Clinical Psychologist 1951555226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Villar Neuropsychology, LLCGroup PAC ID 8729396999, 4 clinicians

Practice addresses (Care Compare)

2500 W Lake Mary Blvd
Suite 110
Lake Mary, FL 32746-3501
Phone (407) 906-8843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 8696FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maitland Psychology PA Clinical Neuropsychologist CurrentSince Feb 1, 2013 Accepting new patients
Kristin P. Girardot, PH.D, LLC CurrentSince Feb 1, 2013 Accepting new patients
Villar Neuropsychology, LLC Clinical Neuropsychologist CurrentSince Sep 14, 2015 Accepting new patients

Locations

2500 W Lake Mary Blvd
Ste 110
Lake Mary, FL 32746
Phone (407) 906-8843

500 N Maitland Ave
Ste 110
Maitland, FL 32751
Phone (407) 628-5354

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": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1174862882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 S INTERNATIONAL PKWY",
            "address_2": "STE 2471",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461694",
            "telephone_number": "407-906-8843",
            "fax_number": "888-335-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 S INTERNATIONAL PKWY",
            "address_2": "STE 2471",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461694",
            "telephone_number": "407-906-8843",
            "fax_number": "888-335-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAR",
        "first_name": "REBECCA",
        "middle_name": "C",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 8696",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY8696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.