Individual provider Active NPI

Mateo Villa

  • Surgery Physician
  • Miami, FL
National Provider Identifier
1316400534
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DR.0073680 Issued in CO
Practice address
11750 Bird Rd
Miami, FL 33175-3530
Phone
(305) 223-2000
NPI assigned
Apr 14, 2019
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X DR.0073680 CO Primary

Addresses

Primary practice location

11750 Bird Rd
Miami, FL 33175-3530

Mailing address

1859 American Way
Lawrenceville, GA 30043-6614
Phone (404) 202-3261

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251125001194 GA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 7618323395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Medical College of Georgia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0073680COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Surgery CurrentSince Oct 6, 2025 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Oct 6, 2025 Accepting new patients
The Emory Clinic Inc CurrentSince Oct 6, 2025 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Emory Health Care Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

2665 N Decatur Rd
Decatur, GA 30033
Phone (404) 299-2223

2675 N Decatur Rd
Decatur, GA 30033
Phone (404) 292-1144

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

450 N Candler St
Decatur, GA 30030
Phone (404) 501-6100

6325 Hospital Pkwy
Johns Creek, GA 30097
Phone (404) 251-1880

5910 Hillandale Dr
Lithonia, GA 30058
Phone (404) 501-8733

5665 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (678) 843-7001

5673 Peachtree Dunwoody Rd
Ste 320
Sandy Springs, GA 30342
Phone (404) 855-5660

2801 DeKalb Medical Pkwy
Stonecrest, GA 30058
Phone (404) 501-5374

Interoperability endpoints

  • Direct secure messaging: mvilla1196801@direct.emory.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1316400534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 AMERICAN WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436614",
            "telephone_number": "404-202-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 BIRD RD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753530",
            "telephone_number": "305-223-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "MATEO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR.0073680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.