Raul Luis Vilca, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

41816 Issued in KY

Practice address

12510 Queens Blvd
Kew Gardens, NY 11415-1519

Phone

(718) 261-0444

Fax

(718) 261-0940

NPI assigned

Jun 3, 2008

Last updated

Nov 16, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

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

Cardiovascular Disease (Cardiology)Also: Nuclear Medicine

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marian David MD PCGroup PAC ID 6406743442, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Marian David, MD, PC

  • Specialist
  • Kew Gardens, NY
  • NPI 1194721043
  Medicare reassignment Care Compare group NPD
• Marian David, MD PC

  • Specialist
  • Brooklyn, NY
  • NPI 1215106554
  NPD (past)
• Cumberland Clinic PLLC

  dba Cumberland Clinic ARNP Group

  • Nurse Practitioner
  • London, KY
  • NPI 1992948848
  NPD (past)
• Cumberland Clinic, PLLC

  • Cardiovascular Disease Physician
  • London, KY
  • NPI 1457432247
  NPD (past)

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1447419726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9608",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115559608",
            "telephone_number": "718-261-0444",
            "fax_number": "718-261-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12510 QUEENS BLVD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151519",
            "telephone_number": "718-261-0444",
            "fax_number": "718-261-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILCA",
        "first_name": "RAUL",
        "middle_name": "LUIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "41816",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "KY",
            "license": "41816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100055030",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "265821",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000584955",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• US Institute, Inc
• Michiko Alla Uy
• Diana Valencia
• Virgilio Lopez Valencia, RN
• Kenneth Veliky, DC
• Vidhi Pramod Vora
• VS Medical Supply Inc
• Keyonna Wallace
• Dorine Walski, OT/L
• Dikyi Wangmo

• Interventional Cardiology Physician in Kew Gardens, NY
• Providers in Kew Gardens, NY by specialty
• Interventional Cardiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.