Active NPI
Candelario Villanueva, DISPENSUNG OPTICIAN
- Optician
- Anchorage, AK
National Provider Identifier
1477722296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- AA159
- Practice address
- 3500 Latouche St
Suite 110
Anchorage, AK 99508-4209 - Phone
- (907) 562-2845
- Fax
- (907) 562-2956
- NPI assigned
- Feb 26, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | AA159 | AK | Primary |
Addresses
Primary practice location
3500 Latouche St
Suite 110
Anchorage, AK 99508-4209
Mailing address
3500 Latouche St
Suite 110
Anchorage, AK 99508-4209
Phone (907) 562-2845
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OP1159 | Medicaid | AK |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AA159 | AK | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Plastics USA Inc. | Optician | Past | 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 and National Provider Directory roles.
-
- Optician
- Anchorage, AK
- NPI 1659612315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203984000000",
"number": "1477722296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 LATOUCHE ST",
"address_2": "SUITE 110",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084209",
"telephone_number": "907-562-2845",
"fax_number": "907-562-2956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 LATOUCHE ST",
"address_2": "SUITE 110",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084209",
"telephone_number": "907-562-2845",
"fax_number": "907-562-2956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLANUEVA",
"first_name": "CANDELARIO",
"name_prefix": "Mr.",
"credential": "DISPENSUNG OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-26",
"last_updated": "2008-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "AK",
"license": "AA159",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OP1159",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.