Individual provider Active NPI

Carlos Villanueva, PT, DPT

  • Physical Therapist
  • Tempe, AZ
National Provider Identifier
1245041763
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-034027 Issued in AZ
Practice address
2140 E 5TH St Ste 8
Tempe, AZ 85288-3043
Phone
(480) 474-4921
NPI assigned
Jan 15, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-034027 AZ Primary

Addresses

Primary practice location

2140 E 5TH St Ste 8
Tempe, AZ 85288-3043

Mailing address

2177 S McQueen Rd Apt 3098
Chandler, AZ 85286-1852
Phone (520) 878-6772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250205003295 AZ Practitioner - Physical Therapist in Private Practice 4385174366

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Performance InstituteGroup PAC ID 1052787017, 4 clinicians

Practice addresses (Care Compare)

8607 E Pecos Rd
Suite 116
Mesa, AZ 85212-9307
Phone (480) 500-1446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-034027AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Performance Institute Physical Therapist CurrentSince May 9, 2026 Accepting new patients
Gmclarty Enterprises LLC Physical Therapist CurrentSince Jan 19, 2025 Accepting new patients

Locations

8607 E Pecos Rd
Ste 116
Mesa, AZ 85212
Phone (480) 500-1446

1425 W 14th St
Ste 101
Tempe, AZ 85281
Phone (480) 474-4921

2140 E 5th St
Ste 8
Tempe, AZ 85288
Phone (480) 474-4921

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1245041763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 S MCQUEEN RD APT 3098",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861852",
            "telephone_number": "520-878-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 E 5TH ST STE 8",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852883043",
            "telephone_number": "480-474-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-034027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.