Mario Raul Villalba, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301084028 Issued in MI

Practice address

3535 W 13 Mile Rd
Suite 501
Royal Oak, MI 48073-6770

Phone

(248) 288-1130

NPI assigned

May 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

Wayne State University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
• Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mvillalba1458548@epic00.shdirect.org

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.

• Beaumont Medical Group Hospital -Based Services

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1427567858
  Medicare reassignment Care Compare group NPD
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment Care Compare group NPD
• Michigan Healthcare Professionals PC

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  NPD (past)

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

• Botsford General Hospital

  • Podiatrist
  • Farmington Hills, MI
  • NPI 1093828303

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Family Medicine Physician
  • Dearborn Heights, MI
  • NPI 1114935566

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • General Acute Care Hospital
  • Farmington Hills, MI
  • NPI 1336183367
  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1538103395

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Family Medicine Physician
  • Farmington Hills, MI
  • NPI 1871521153

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1871907303

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1912335373

  Hospital

  Care Compare affiliation
• Botsford General Hospital

  • Pulmonary Disease Physician
  • Farmington Hills, MI
  • NPI 1912915349

  Hospital

  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1285849190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "SUITE 501",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-288-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "SUITE 501",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-288-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALBA",
        "first_name": "MARIO",
        "middle_name": "RAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301084028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvillalba14829@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3535 W 13 Mile Rd",
            "address_2": "Suite 501",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vibrance of Life
• Shirley Marie Vicente-Castro, NP-C
• Lexis Victor
• Rachel Victor, CCC-SLP
• Mario Villalba, MD
• Paul Villalba, M.D.
• Silvia Morena Villalobos
• Anne Villerot
• Crystal S Vinson
• Deborah L Virant-Young, PHARMD

• Surgery Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.