Roberto M Villasenor, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

C10001573 Issued in DE

Practice address

916 Middleford Rd
Seaford, DE 19973-3604

Phone

(302) 629-7605

Fax

(302) 629-2323

NPI assigned

Jul 14, 2005

Reactivated

Mar 31, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1497753255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733604",
            "telephone_number": "302-629-7605",
            "fax_number": "302-629-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733604",
            "telephone_number": "302-629-7605",
            "fax_number": "302-629-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLASENOR",
        "first_name": "ROBERTO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2007-12-07",
        "deactivation_date": "2006-03-24",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "DE",
            "license": "C10001573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103501",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Seaford, DE
• Providers in Seaford, DE by specialty
• Adult Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.