Active NPI
Michael Villareale, MD
- Anesthesiology Physician
- Rochester, NY
National Provider Identifier
1255377974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 160708-1
- Practice address
- 1425 Portland Ave
Rochester General Hospital
Rochester, NY 14621-3001 - Phone
- (585) 922-4159
- Fax
- (585) 922-3731
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 160708-1 | NY | Primary |
Addresses
Primary practice location
1425 Portland Ave
Rochester General Hospital
Rochester, NY 14621-3001
Mailing address
130 Allens Creek Rd
Rochester, NY 14618-3305
Phone (585) 410-6545
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01106990 | Medicaid | NY | |
| 3436 | Other | NY | EXCELLUS BC/BS |
| 103217AF | Other | NY | PREFERRED CARE |
| CAN160708-4 | Other | NY | WORKERS' COMPENSATION |
| P010160708 | Other | NY | EXCELLUS BLUE CHOICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160708-1 | NY | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1255377974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 ALLENS CREEK RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146183305",
"telephone_number": "585-410-6545",
"fax_number": "585-410-6560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 PORTLAND AVE",
"address_2": "ROCHESTER GENERAL HOSPITAL",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146213001",
"telephone_number": "585-922-4159",
"fax_number": "585-922-3731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLAREALE",
"first_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "160708-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01106990",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS BC/BS",
"identifier": "3436",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "103217AF",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS' COMPENSATION",
"identifier": "CAN160708-4",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS BLUE CHOICE",
"identifier": "P010160708",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.