NPIMap

Individual provider Active NPI

Nicolas Alfonso Villa Guillen, M.D.

  • Gastroenterology Physician
  • Spokane, WA
National Provider Identifier
1265696553
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD60501812 Issued in WA
Practice address
910 W 5TH Ave Ste 501
Spokane, WA 99204-2967
Phone
(509) 838-2531
Fax
(509) 755-6580
NPI assigned
Jul 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD60501812 WA Primary
Internal Medicine Physician 207R00000X BP10031201 TX

Addresses

Primary practice location

910 W 5TH Ave Ste 501
Spokane, WA 99204-2967

Mailing address

1200 Airport Heights Dr
Ste 210
Anchorage, AK 99508-2969
Phone (509) 939-4539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150723007220 WA Practitioner - Gastroenterology 7113148651 Reassigns benefits to 1 organization
I20210929002489 AK Practitioner - Gastroenterology 7113148651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Gi Clinic, ApcGroup PAC ID 1759466964, 7 clinicians
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

1200 Airport Heights Dr
Suite 210
Anchorage, AK 99508-2969
Phone (907) 562-6001

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

910 W 5TH Ave
Spokane, WA 99204-2967

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy162
Upper gastrointestinal (GI) endoscopy for acid reflux543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10031201TXMDInternal Medicine Physician
MD60501812WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System Internal Medicine CurrentSince Mar 1, 2018 Accepting new patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Rockwood Clinic PS Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

910 W 5th Ave
Ste 501
Spokane, WA 99204
Phone (509) 755-5220

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: nvillaguillen330979@direct.multicare.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1265696553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 AIRPORT HEIGHTS DR",
            "address_2": "STE 210",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082969",
            "telephone_number": "509-939-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 W 5TH AVE STE 501",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042967",
            "telephone_number": "509-838-2531",
            "fax_number": "509-755-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA GUILLEN",
        "first_name": "NICOLAS",
        "middle_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD60501812",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10031201",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.