Individual provider Active NPI

Edward Eusebio Villanueva, DPM

  • Podiatrist
  • Drexel Hill, PA
National Provider Identifier
1346233053
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC003875L Issued in PA
Practice address
2501 Garrett Rd
Drexel Hill, PA 19026-1010
Phone
(610) 623-3540
Fax
(610) 623-2327
NPI assigned
Aug 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC003875L PA Primary
Foot Surgery Podiatrist 213ES0131X SC003875L PA

Addresses

Primary practice location

2501 Garrett Rd
Drexel Hill, PA 19026-1010

Mailing address

2501 Garrett Rd
Drexel Hill, PA 19026-1010
Phone (610) 623-3540

Other identifiers 1

IdentifierTypeStateIssuer
0015260540002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080331000165 PA Practitioner - Podiatry 9436235520 Receives reassigned benefits from 1 practitioner
Practice locations: Drexel Hill, PA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2501 Garrett Rd
Drexel Hill, PA 19026-1010
Phone (610) 623-3540

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue2116
Removal or shaving of skin growth924

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC003875LPAMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward E Villanueva DPM Podiatrist CurrentSince Jul 29, 1996 Accepting new patients
Wiemer Family Podiatry, LLC Foot Surgery Past Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

NPI Registry JSON

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

{
    "created_epoch": "1125100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1346233053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 GARRETT RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190261010",
            "telephone_number": "610-623-3540",
            "fax_number": "610-623-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 GARRETT RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190261010",
            "telephone_number": "610-623-3540",
            "fax_number": "610-623-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "EDWARD",
        "middle_name": "EUSEBIO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-27",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC003875L",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC003875L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015260540002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Drexel Hill, PA

Sources for this page

Verify at the official NPI Registry.