Michael Villas, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1497513931 Issued in SD

Practice address

5627 S 11TH St
Grand Forks, ND 58201-3632

Phone

(701) 330-4510

NPI assigned

Mar 11, 2024

Last updated

Aug 3, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1497513931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 OREGON AVE SE",
            "city": "HURON",
            "state": "SD",
            "postal_code": "573502801",
            "telephone_number": "605-353-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5627 S 11TH ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013632",
            "telephone_number": "701-330-4510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "534 Oregon Ave SE",
            "address_purpose": "LOCATION",
            "city": "Huron",
            "state": "SD",
            "postal_code": "573502801",
            "country_code": "US",
            "telephone_number": "605-353-7660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLAS",
        "first_name": "MICHAEL",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-11",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SD",
            "license": "1497513931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Medical Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.