Individual provider Active NPI

Jorge Arturo Villafuerte Vallejos, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Boston, MA
National Provider Identifier
1184732919
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
226375 Issued in MA
Practice address
150 S Huntington Ave
Boston, MA 02130-4817
Phone
(617) 232-9500
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 226375 MA
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 226375 MA Primary

Addresses

Primary practice location

150 S Huntington Ave
Boston, MA 02130-4817

Mailing address

3806 Stearns Hill Rd
Waltham, MA 02451-7118
Phone (781) 652-1530

Other identifiers 1

IdentifierTypeStateIssuer
226375OtherMAFULL MEDICAL LICENSE

Other names 1

  • Jorge A. Villafuerte Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140915001562 MA Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 3072732528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
226375MAMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1184732919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3806 STEARNS HILL RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024517118",
            "telephone_number": "781-652-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "617-232-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAFUERTE VALLEJOS",
        "first_name": "JORGE",
        "middle_name": "ARTURO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "226375",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "MA",
            "license": "226375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FULL MEDICAL LICENSE",
            "identifier": "226375",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORGE",
            "last_name": "VILLAFUERTE",
            "middle_name": "A.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.