Enrique Villavicencio Sumire, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

R75314 Issued in AZ

Practice address

135 Plaza Dr Ste 102
Sikeston, MO 63801-5148

Phone

(573) 471-6010

NPI assigned

Jul 7, 2015

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

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Health Facilities Rehab Services IncGroup PAC ID 3476679226, 152 clinicians

Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113
• Deaconess Illinois Union County Hospital, Anna, IL, CCN 141342
• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
  • NPI 1508967860

  Neurology

  Medicare reassignment Care Compare group NPD
• Health Facilities Rehab Services Inc

  • Rehabilitation Clinic/Center
  • Sikeston, MO
  • NPI 1720003551
  Care Compare group
• Missouri Delta Medical Center

  dba Delta Regional Pharmacy

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation
• Missouri Delta Medical Center

  • General Acute Care Hospital
  • Sikeston, MO
  • NPI 1831269539
  Care Compare affiliation
• Deaconess Illinois Union County Hospital Inc

  dba Deaconess Illinois Union County

  • Critical Access Hospital
  • Anna, IL
  • NPI 1710604483
  Care Compare affiliation

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1386027506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-471-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PLAZA DR STE 102",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015148",
            "telephone_number": "573-471-6010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 E Ajo Way",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857136204",
            "country_code": "US",
            "telephone_number": "520-874-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLAVICENCIO SUMIRE",
        "first_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "R75314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred K Uthoff
• David Michael Van Pelt, PSY.D
• Angela Christine Vandenberghe, OTR/L
• Christy Leanne Vandeven, RPH
• Stas Vidyakin, DMD
• Annah J Voshage, MA, CF-SLP
• Gloria H Voss, LPC
• Daryl Gene Wade II, PTA
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0009)
• Wal-Mart Stores East, LP (Vision Center 30-0009)

• Neurology Physician in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Neurology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.