Individual provider Active NPI

Richard J Villanueva, D.P.T.

  • Orthopedic Physical Therapist
  • Jbphh, HI
National Provider Identifier
1437244068
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2579 Issued in HI
Practice address
755 Scott Cir
Jbphh, HI 96853-5399
Phone
(808) 448-6137
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 2579 HI Primary
Orthopedic Physical Therapist 2251X0800X 32591 CA
Orthopedic Physical Therapist 2251X0800X 013745 AZ
Orthopedic Physical Therapist 2251X0800X 1935 NV

Addresses

Primary practice location

755 Scott Cir
Jbphh, HI 96853-5399

Mailing address

755 Scott Cir
Jbphh, HI 96853-5399
Phone (808) 448-6137

Other identifiers 1

IdentifierTypeStateIssuer
100508900MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32591CAMDGeneral Practice Dentistry
013745AZMDOrthopedic Physical Therapist
2579HIMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosport Physical Therapy and Sports Performance, Inc Orthopedic PastSince Apr 1, 2002 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1437244068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "HI",
            "license": "2579",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "32591",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "013745",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NV",
            "license": "1935",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508900",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbphh, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.