Individual provider Active NPI

Andres Gabriel Villanueva, MSW

  • Clinical Social Worker
  • Rio Grande, PR
National Provider Identifier
1316531049
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15289 Issued in PR
Practice address
Industrial Park Las Flores Carr 3 KM 23.9
Rio Grande, PR 00745
Phone
(787) 704-0705
NPI assigned
Feb 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 15289 PR Primary

Addresses

Primary practice location

Industrial Park Las Flores Carr 3 KM 23.9
Rio Grande, PR 00745

Mailing address

PO Box 9809
Caguas, PR 00726-9809
Phone (787) 704-0705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210315000319 PR Practitioner - Clinical Social Worker 4587070784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neomed Center, IncGroup PAC ID 1850284100, 66 clinicians

Practice addresses (Care Compare)

11 Calle Condado
San Lorenzo, PR 00754-4214
Phone (787) 715-1260

Ctro de Med de Fam
11 C Condado
San Lorenzo, PR 00754-4214
Phone (787) 715-3620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15289PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neomed Center, Inc Current Accepting new patients
Neomed Center, Inc Current Accepting new patients
Neomed Center, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Neomed Center, Inc. CurrentSince Jan 1, 2022 Accepting new patients

Locations

11 Calle Condado
San Lorenzo, PR 00754
Phone (787) 715-1260

Organizations & group practices 4

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": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1316531049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9809",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007269809",
            "telephone_number": "787-704-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INDUSTRIAL PARK LAS FLORES CARR 3 KM 23.9",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "00745",
            "telephone_number": "787-704-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "ANDRES",
        "middle_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "15289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, PR

Sources for this page

Verify at the official NPI Registry.