Michael Villaverde Villanueva, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA15429 Issued in CA

Practice address

126 Avocado Ave Ste 207
Perris, CA 92571-2605

Phone

(951) 657-0544

Fax

(951) 657-9644

NPI assigned

Apr 3, 2006

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

Other names 1

• Mr. Michael Villaverde Villanueva Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Perris Valley Medical Group IncGroup PAC ID 5597817841, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AHEBBA/Endpoint/AHEBBA

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.

• Perris Valley Medical Group, Inc.

  • Family Medicine Physician
  • Perris, CA
  • NPI 1083851703
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1316909757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 AVOCADO AVE STE 207",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925712605",
            "telephone_number": "951-657-0544",
            "fax_number": "951-657-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 AVOCADO AVE STE 207",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925712605",
            "telephone_number": "951-657-0544",
            "fax_number": "951-657-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "MICHAEL",
        "middle_name": "VILLAVERDE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "VILLANUEVA",
            "middle_name": "VILLAVERDE",
            "prefix": "MR.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nancy Guadalupe Vieyra
• Maria de la Luz Lopez Villa
• Alanna Villanueva
• Dimitri Villanueva
• George Villanueva, DO
• Sally Ann Villanueva, FNP
• Valerie Sofia Villanueva
• Bianca Camille V. Violeta
• Vip Pharmacy Inc
• Richa Wadhawan

• Physician Assistant in Perris, CA
• Providers in Perris, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.