NPIMap

Individual provider Active NPI

Juan Miguel Villarreal, PA-C

  • Physician Assistant
  • San Juan, TX
National Provider Identifier
1245658269
Registry record updated May 30, 2018
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Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1229 S Veterans Blvd
San Juan, TX 78589
Phone
(956) 787-5454
Fax
(956) 787-5486
NPI assigned
Apr 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

1229 S Veterans Blvd
San Juan, TX 78589

Mailing address

PO Box 749
Pharr, TX 78577-1614
Phone (956) 787-5454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151210001076 TX Practitioner - Physician Assistant 5799086005 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.24 of 100Reported as group
Quality
73.33
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SSC Nueces Retama LLC CurrentSince Oct 31, 2015 Accepting new patients
RFC Radiology Associates LLC Past Accepting new patients

Locations

128 N FM 3167
Rio Grande Cy, TX 78582
Phone (956) 487-0453

Organizations & group practices 8

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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1245658269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785771614",
            "telephone_number": "956-787-5454",
            "fax_number": "956-787-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 S VETERANS BLVD",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "78589",
            "telephone_number": "956-787-5454",
            "fax_number": "956-787-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "JUAN",
        "middle_name": "MIGUEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, TX

Sources for this page

Verify at the official NPI Registry.