Active NPI
Mauricio Fernando Villamar Davila, M.D.
- Neurology Physician
- Warwick, RI
National Provider Identifier
1346655032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- MD16954
- Practice address
- 455 Toll Gate Rd
Warwick, RI 02886-2759 - Phone
- (401) 736-1011
- NPI assigned
- Jun 22, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | MD16954 | RI | Primary |
| Neurology Physician | 2084N0400X | 274431 | MA |
Addresses
Primary practice location
455 Toll Gate Rd
Warwick, RI 02886-2759
Mailing address
455 Toll Gate Rd
PRC and Credentialing
Warwick, RI 02886-2759
Phone (401) 273-0641
Other practice location 1
60 Fenwood Rd Fl
Boston, MA 02115-6128
Phone (857) 307-2390
Other names 1
- Mauricio Fernando Villamar
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010
Hospital & facility affiliations
- Kent County Memorial Hospital
- Rhode Island Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 274431 | MA | MD | Neurology Physician |
| MD16954 | RI | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kent County Memorial Hospital | Neurology | Current | Accepting new patients |
| Affinity Physicians LLC. | Neurology | Current | Accepting new patients |
| Kent County Memorial Hospital | Current | Accepting new patients | |
| Affinity Physicians LLC | Current | Accepting new patients |
Locations
345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375
455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000
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.
-
- Anesthesiology Physician
- Providence, RI
- NPI 1053038471
-
- Rehabilitation Hospital Unit
- Warwick, RI
- NPI 1023017944
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Warwick, RI
- NPI 1023017944
-
- General Acute Care Hospital
- Warwick, RI
- NPI 1386643294
-
- General Acute Care Hospital
- Providence, RI
- NPI 1588659528
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595548800000",
"number": "1346655032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 TOLL GATE RD",
"address_2": "PRC AND CREDENTIALING",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862759",
"telephone_number": "401-273-0641",
"fax_number": "401-273-2919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 TOLL GATE RD",
"city": "WARWICK",
"state": "RI",
"postal_code": "028862759",
"telephone_number": "401-736-1011"
}
],
"practiceLocations": [
{
"address_1": "60 Fenwood Rd Fl",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021156128",
"country_code": "US",
"telephone_number": "857-307-2390",
"fax_number": "617-278-6963",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VILLAMAR DAVILA",
"first_name": "MAURICIO",
"middle_name": "FERNANDO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-22",
"last_updated": "2020-07-24",
"certification_date": "2020-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "RI",
"license": "MD16954",
"primary": true
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MA",
"license": "274431",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MAURICIO",
"last_name": "VILLAMAR",
"middle_name": "FERNANDO",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.