Individual provider Active NPI

Vincent Andry Villanueva, PT

  • Physical Therapist
  • Briarwood, NY
National Provider Identifier
1255632980
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031185 Issued in NY
Practice address
8431 Van Wyck Expy
Apt 3-J
Briarwood, NY 11435-2611
Phone
(917) 645-3620
NPI assigned
Nov 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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 031185 NY Primary

Addresses

Primary practice location

8431 Van Wyck Expy
Apt 3-J
Briarwood, NY 11435-2611

Mailing address

8431 Van Wyck Expy
Apt 3-J
Briarwood, NY 11435-2611
Phone (917) 645-3620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250507001978 NY Practitioner - Physical Therapist in Private Practice 8224555834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mangoos Physical Therapy P.C CurrentSince Apr 1, 2025 Accepting new patients
Dynakinetics PT PC Past Accepting new patients

Locations

825 Walton Ave
Bronx, NY 10451
Phone (718) 402-1800

903 Sheridan Ave
Bronx, NY 10451
Phone (347) 605-7946

10603 Corona Ave
Flushing, NY 11368
Phone (917) 745-0091

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": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1255632980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8431 VAN WYCK EXPY",
            "address_2": "APT 3-J",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114352611",
            "telephone_number": "917-645-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8431 VAN WYCK EXPY",
            "address_2": "APT 3-J",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114352611",
            "telephone_number": "917-645-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "VINCENT ANDRY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-11",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Briarwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.