Amanda M Villagomez, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.028589 Issued in IL

Practice address

2440 S Laramie Ave Unit 50646
Cicero, IL 60804-5147

Phone

(773) 414-6881

NPI assigned

Feb 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Podiatry at Your Door by Dr Garcia, PCGroup PAC ID 1052662475, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Podiatry at Your Door by Dr. Garcia, P.C.

  • Podiatrist
  • Mount Prospect, IL
  • NPI 1821576687
  Medicare reassignment Care Compare group NPD
• Amv Medical LLC

  • Family Nurse Practitioner
  • Mount Prospect, IL
  • NPI 1528899796
  NPD Authorized official

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1255196267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 S LARAMIE AVE UNIT 50646",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608045147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 S LARAMIE AVE UNIT 50646",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608045147",
            "telephone_number": "773-414-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAGOMEZ",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.028589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arelly Vargas
• VDC Cicero Corp
• Maria Isela Vega
• Grasiela Victor
• Lisa Vihnanek, D.D.S.
• Ana Isabel Villasana, LMT
• Araceli Villasenor-Molina
• Alessandra Danielle Villela
• Tuyet Vo, RPH
• Frank Vonwesternhagen, D.D.S.

• Family Nurse Practitioner in Cicero, IL
• Providers in Cicero, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.