Individual provider Active NPI

Alyssa Judith Villanueva, MD

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1386492031
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
BP10088349 Issued in TX
Practice address
1501 Red River St FL 2
Austin, TX 78712-1845
Phone
(512) 495-5555
NPI assigned
May 8, 2024
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP10088349 TX Primary

Addresses

Primary practice location

1501 Red River St FL 2
Austin, TX 78712-1845

Mailing address

1501 Red River St FL 2
Austin, TX 78712-1845
Phone (512) 495-5555

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240613001742 TX Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9537602933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10088349TXMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1386492031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 RED RIVER ST FL 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121845",
            "telephone_number": "512-495-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 RED RIVER ST FL 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121845",
            "telephone_number": "512-495-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "ALYSSA",
        "middle_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10088349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.