Individual provider Active NPI

Javier Villalobos, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1528120326
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
10566 Issued in PR
Practice address
Calle Padre Las Casas #107 Urbanizacion El Vedado
San Juan, PR 00918
Phone
(787) 767-8758
Fax
(844) 759-2966
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 10566 PR Primary

Addresses

Primary practice location

Calle Padre Las Casas #107 Urbanizacion El Vedado
San Juan, PR 00918

Mailing address

PO Box 193044
San Juan, PR 00919-3044
Phone (787) 767-8758

Other identifiers 1

IdentifierTypeStateIssuer
37727700MedicaidPR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329000726 PR Practitioner - General Practice 2961394432 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Grupo de Empresas de Salud de San Juan, Inc CurrentSince Jul 12, 2012 Accepting new patients
Grupo de Empresas de Salud de San Juan, Inc CurrentSince Jul 12, 2012 Accepting new patients
Physician H.M.O. Inc. CurrentSince Feb 29, 2016 Accepting new patients
Ges de San Juan, Inc. Past Accepting new patients
Exclusive Medical Supply & Respiratory Services, Inc Past Accepting new patients

Locations

107 Calle Padre Las Casas
San Juan, PR 00918
Phone (787) 294-7801

Organizations & group practices 5

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1528120326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193044",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009193044",
            "telephone_number": "787-767-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE PADRE LAS CASAS #107 URBANIZACION EL VEDADO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-767-8758",
            "fax_number": "844-759-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "10566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37727700",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.