Active NPI
Cynthia D. Villasis, MD
- Neonatal-Perinatal Medicine Physician
- Pomona, NJ
National Provider Identifier
1598718579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- MD036907L
- Practice address
- 65 W Jimmie Leeds Rd
Chop Care Network @ Atlanticare
Pomona, NJ 08240-9102 - Phone
- (609) 404-3816
- NPI assigned
- May 18, 2006
- Last updated
- Mar 24, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD036907L | PA | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | MD036907L | PA | Primary |
Addresses
Primary practice location
65 W Jimmie Leeds Rd
Chop Care Network @ Atlanticare
Pomona, NJ 08240-9102
Mailing address
100 E Penn SQ
9TH Floor
Philadelphia, PA 19107-3323
Phone (267) 425-9232
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2253288 | Other | PA | CIGNA HMO/PPO |
| 0007930170010 | Medicaid | PA | |
| 10938189 | Other | PA | CAQH ID# |
| 417451 | Other | PA | HIGHMARK BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD036907L | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395619200000",
"number": "1598718579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E PENN SQ",
"address_2": "9TH FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191073323",
"telephone_number": "267-425-9232",
"fax_number": "267-425-9299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 W JIMMIE LEEDS RD",
"address_2": "CHOP CARE NETWORK @ ATLANTICARE",
"city": "POMONA",
"state": "NJ",
"postal_code": "082409102",
"telephone_number": "609-404-3816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLASIS",
"first_name": "CYNTHIA",
"middle_name": "D.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2014-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD036907L",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "PA",
"license": "MD036907L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HMO/PPO",
"identifier": "2253288",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0007930170010",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH ID#",
"identifier": "10938189",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "417451",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pomona, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.