Dominique N Villalba, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8037 Issued in WI

Practice address

2727 Plaza Dr
Wausau, WI 54401-4192

Phone

(715) 847-3000

NPI assigned

Dec 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ, WI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center - Weston Hospital, Weston, WI, CCN 520202
• Marshfield Medical Center Hospital, Marshfield, WI, CCN 520037

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

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.

• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment Care Compare group NPD
• Beaver Dam Community Hospitals Inc

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1972188555
  Medicare reassignment NPD
• Flambeau Hospital Inc

  • Clinic/Center
  • Park Falls, WI
  • NPI 1194317966
  Medicare reassignment NPD
• Lakeview Medical Center Inc of Rice Lake

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1093201832
  Medicare reassignment NPD
• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• Memorial Hospital Inc

  • Critical Access Hospital
  • Neillsville, WI
  • NPI 1346239373
  Medicare reassignment NPD
• Effideen Ameerally MD PC

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1891740296
  Medicare reassignment
• Integrity Pain and Anesthesia PLLC

  • Pain Medicine Physician
  • Scottsdale, AZ
  • NPI 1386049070
  Medicare reassignment
• Kpa Medical LLC

  • Anesthesiology Physician
  • Scottsdale, AZ
  • NPI 1619374048
  Medicare reassignment
• Flambeau Hospital Inc

  • Critical Access Hospital
  • Park Falls, WI
  • NPI 1700963048
  NPD
• Lakeview Medical Center Inc of Rice Lake

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1790320687
  NPD
• MCHS Hospitals Inc

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• MCHS Hospitals Inc

  • General Acute Care Hospital
  • Weston, WI
  • NPI 1902437650
  Care Compare affiliation
• MCHS Hospitals Inc

  • Rural Acute Care Hospital
  • Marshfield, WI
  • NPI 1942749387
  Care Compare affiliation

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1265143275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 PLAZA DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014192",
            "telephone_number": "715-847-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850042157",
            "country_code": "US",
            "telephone_number": "602-827-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLALBA",
        "first_name": "DOMINIQUE",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8037",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9977",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2727 Plaza Dr",
            "city": "Wausau",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544014192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John James Verre, D.O.
• Pamela J Vetter, ACNS-BC, APNP
• Kirsten R Vetterkind, FNP
• Anastasia Viars, LPC-IT
• Jill Rae Viergutz, BSN, RN
• Maria Cristina Villena Odriozola
• Denise Visconte, DACM, MAOM, MSC CHM
• Gordon Vittone, CRNA
• Vivera SLP LLC
• Carl J Viviano, M.D.

• Physician Assistant in Wausau, WI
• Providers in Wausau, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.