Active NPI
Karen Villacres
- Specialist
- Ridgewood, NY
National Provider Identifier
1497222079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 506 Grandview Ave Apt 2R
Ridgewood, NY 11385-1996 - Phone
- (347) 350-0596
- NPI assigned
- Oct 31, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | NY | Primary |
Addresses
Primary practice location
506 Grandview Ave Apt 2R
Ridgewood, NY 11385-1996
Mailing address
506 Grandview Ave Apt 2R
Ridgewood, NY 11385-1996
Phone (347) 350-0596
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 630171662 | Other | NY | METRO PLUS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540944000000",
"number": "1497222079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 GRANDVIEW AVE APT 2R",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113851996",
"telephone_number": "347-350-0596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 GRANDVIEW AVE APT 2R",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113851996",
"telephone_number": "347-350-0596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLACRES",
"first_name": "KAREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-31",
"last_updated": "2018-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METRO PLUS",
"identifier": "630171662",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.