Individual provider Active NPI

Vilca Fauiki Havili, PA-C

  • Physician Assistant
  • Myrtle Creek, OR
National Provider Identifier
1326748633
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
790 S Main St
Myrtle Creek, OR 97457-9303
Phone
(541) 860-4070
NPI assigned
Mar 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

790 S Main St
Myrtle Creek, OR 97457-9303

Mailing address

150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042
Phone (541) 672-9596

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251118003004 OR Practitioner - Physician Assistant 4587155403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umpqua Community Health Center IncGroup PAC ID 0345233078, 33 clinicians

Practice addresses (Care Compare)

150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042
Phone (541) 672-9596

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Umpqua Community Health Center, Inc. CurrentSince Nov 3, 2025 Accepting new patients
Umpqua Community Health Center, Inc. CurrentSince Nov 3, 2025 Accepting new patients

Locations

790 S Main St
Myrtle Creek, OR 97457
Phone (541) 860-4070

150 NE Kenneth Ford Dr
Roseburg, OR 97470

Interoperability endpoints

  • Direct secure messaging: vilca.havili.1@17792.direct.athenahealth.com

Organizations & group practices 2

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 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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1326748633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NE KENNETH FORD DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701042",
            "telephone_number": "541-672-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 S MAIN ST",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "974579303",
            "telephone_number": "541-860-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVILI",
        "first_name": "VILCA",
        "middle_name": "FAUIKI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Creek, OR

Sources for this page

Verify at the official NPI Registry.