Organization Active NPI

Villa Health Pulmonary LLC

  • Pulmonary Disease Physician
  • The Villages, FL
National Provider Identifier
1437780830
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
VILLA HEALTH PULMONARY LLC
Practice address
1507 Buenos Aires Blvd
The Villages, FL 32159-8974
Phone
(352) 561-6299
NPI assigned
Feb 4, 2020
Last updated
Feb 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Authorized official

Name
Dr. Marivic Villa, MDNPI 1629092564
Title
President
Phone
(352) 561-6299

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

1507 Buenos Aires Blvd
The Villages, FL 32159-8974

Mailing address

1507 Buenos Aires Blvd
The Villages, FL 32159-8974
Phone (352) 561-6299

Other identifiers 1

IdentifierTypeStateIssuer
F30701OtherFLUPIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mvilla@villahealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200220000722 FL Part B Supplier - Clinic/Group Practice 5395172985 Receives reassigned benefits from 1 practitioner
Practice locations: The Villages, FL; Wildwood, FL

National Provider Directory

National Provider Directory

Locations

4068 E State Road 44
Wildwood, FL 34785
Phone (352) 564-3655

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1437780830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 BUENOS AIRES BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321598974",
            "telephone_number": "352-561-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 BUENOS AIRES BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321598974",
            "telephone_number": "352-561-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA HEALTH PULMONARY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "MARIVIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-561-6299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "F30701",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvilla@villahealth.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1507 Buenos Aires Blvd",
            "city": "The Villages",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321598974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.