Omar Mijael Villarroel Fernandez, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2018018492 Issued in MO

Practice address

1401 E State St
3Rd Floor
Rockford, IL 61104-2315

Phone

(912) 658-1155

NPI assigned

Feb 15, 2006

Last updated

Apr 21, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 10

Addresses

Other names 1

• Dr. Omar Mijael Villarroel Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, IL, MO3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: omvillar@yourcarecommunity.org
• Direct secure messaging: ovillarroel1642483@direct.trinity-health.org

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.

• Granite City Hospitalist Services LLC

  • Hospitalist Physician
  • Carbondale, IL
  • NPI 1669926424
  Medicare reassignment NPD
• Butler Physician Services, LLC

  • Internal Medicine Physician
  • Poplar Bluff, MO
  • NPI 1982056545

  Pediatrics

  Medicare reassignment NPD
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment NPD

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1457325334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E STATE ST",
            "address_2": "3RD FLOOR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042315",
            "telephone_number": "912-658-1155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11115 Parkview Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451701",
            "country_code": "US",
            "telephone_number": "260-266-5400",
            "fax_number": "260-425-5715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "751 Sappington Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Sullivan",
            "state": "MO",
            "postal_code": "630802354",
            "country_code": "US",
            "telephone_number": "573-468-4186",
            "fax_number": "573-860-6179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061309",
            "country_code": "US",
            "telephone_number": "208-367-6995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLARROEL FERNANDEZ",
        "first_name": "OMAR",
        "middle_name": "MIJAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2018018492",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2008-01887",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036117065",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "MD2005-0619",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "058592",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01068033A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036117065",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2018018492",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "M-16558",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "058592",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "751 Sappington Bridge Rd",
            "city": "Sullivan",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630802354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "OMAR",
            "last_name": "VILLARROEL",
            "middle_name": "MIJAEL",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James M Viggiano, PHD
• Jorge L Villacorta, MD
• Jenna E Villafuerte, LPTA
• Village Chiropractic (Back in Shape Chiropractic and Wellness Center)
• Alejandra Villagomez
• Betty Lou Villiers, APN
• Vincent Facchiano and Associates
• Alix Vincent, MD
• Ann M Vinz, OTR, CHT
• Cori Viola, LPC

• Pediatrics Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.