Individual provider Active NPI

Alan John Villanuevaquisido, PT, DPT

  • Physical Therapist
  • Mason, OH
National Provider Identifier
1467275677
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021423 Issued in OH
Practice address
6020 S Mason Montgomery Rd
Mason, OH 45040-3706
Phone
(513) 204-6495
Fax
(513) 204-6499
NPI assigned
Nov 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT021423 OH Primary

Addresses

Primary practice location

6020 S Mason Montgomery Rd
Mason, OH 45040-3706

Mailing address

6020 S Mason Montgomery Rd
Mason, OH 45040-3706
Phone (513) 204-6495

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250124000271 OH Practitioner - Physical Therapist in Private Practice 4082143839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trihealth H LLCGroup PAC ID 1850570458, 850 clinicians

Practice addresses (Care Compare)

6020 S Mason Montgomery Rd
Mason, OH 45040-3706
Phone (513) 204-6490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth H LLC Physical Therapist CurrentSince Nov 4, 2024 Accepting new patients
Trihealth Physician Institute Past Accepting new patients

Locations

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

6020 S Mason Montgomery Rd
Mason, OH 45040
Phone (513) 204-6490

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1467275677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 S MASON MONTGOMERY RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403706",
            "telephone_number": "513-204-6495",
            "fax_number": "513-204-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 S MASON MONTGOMERY RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403706",
            "telephone_number": "513-204-6495",
            "fax_number": "513-204-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVAQUISIDO",
        "first_name": "ALAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.