Individual provider Active NPI

Fernando Luis Villar Fornes, MD

  • General Practice Physician
  • Carolina, PR
National Provider Identifier
1225719487
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23418 Issued in PR
Practice address
54 Calle de Diego N
Carolina, PR 00985-6032
Phone
(787) 769-4528
NPI assigned
Jul 28, 2023
Last updated
Jul 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 23418 PR Primary

Addresses

Primary practice location

54 Calle de Diego N
Carolina, PR 00985-6032

Mailing address

PO Box 778 Pueblo Station
Carolina, PR 00986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20231025002969 PR Practitioner - General Practice 7416303599 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23418PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital General de Castaner Inc. General Practice CurrentSince Sep 28, 2023 Accepting new patients
Hospital General de Castaner Inc Single Specialty CurrentSince Sep 28, 2023 Accepting new patients

Organizations & group practices 2

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": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1225719487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778 PUEBLO STATION",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 CALLE DE DIEGO N",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009856032",
            "telephone_number": "787-769-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAR FORNES",
        "first_name": "FERNANDO",
        "middle_name": "LUIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "23418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.