Individual provider Active NPI

Rex Villanueva, D.O.

  • Emergency Medicine Physician
  • Issaquah, WA
National Provider Identifier
1417244385
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OP60455082 Issued in WA
Practice address
751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone
(425) 394-0610
NPI assigned
Jun 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OP60455082 WA Primary

Addresses

Primary practice location

751 NE Blakely Dr
Issaquah, WA 98029-6201

Mailing address

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 394-0610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20140912001215 WA Practitioner - Emergency Medicine 2466697370 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

18100 NE Union Hill Rd
Suite 200
Redmond, WA 98052-3330
Phone (206) 320-5190

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 394-0610

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP60455082WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Observation Associates PC CurrentSince Sep 23, 2017 Accepting new patients
Eastside Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
Swedish Health Services CurrentSince Dec 6, 2017 Accepting new patients
Eastside Emergency Physicians PLLC Emergency Medicine Current Accepting new patients
Eastside Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Jul 15, 2014 Accepting new patients
Swedish Health Services Emergency Medicine CurrentSince Dec 6, 2017 Accepting new patients
Swedish Health Services CurrentSince Dec 6, 2017 Accepting new patients
Swedish Health Services CurrentSince Dec 6, 2017 Accepting new patients

Locations

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

751 NE Blakely Dr
Issaquah, WA 98029
Phone (425) 313-4000

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 498-2020

18100 NE Union Hill Rd
Ste 200
Redmond, WA 98052
Phone (206) 320-5190

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

Organizations & group practices 9

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 2

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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1417244385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-394-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-394-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "REX",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP60455082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.