Individual provider Active NPI

Nicholas Lee Villarreal

  • Acute Care Nurse Practitioner
  • Edina, MN
National Provider Identifier
1609392695
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
5385 Issued in MN
Practice address
6401 France Ave S
Edina, MN 55435-2104
Phone
(952) 924-5000
NPI assigned
Aug 21, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 5385 MN Primary

Addresses

Primary practice location

6401 France Ave S
Edina, MN 55435-2104

Mailing address

203 Little John LN
Havelock, NC 28532-9554

Other practice location 1

203 Little John Ln
Havelock, NC 28532-9554
Phone (252) 675-9302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171023000252 MN Practitioner - Nurse Practitioner 7618243460 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5385MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Bethesda Hospital CurrentSince Mar 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Oct 13, 2017 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Mar 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2020 Accepting new patients
Healtheast St. John's Hospital CurrentSince Mar 1, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Sep 4, 2023 Accepting new patients
Healtheast Care System CurrentSince Mar 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2022 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Health Services CurrentSince Oct 13, 2017 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2022 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

2900 Curve Crest Blvd W
Stillwater, MN 55082
Phone (651) 471-5600

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: nvillarreal413575@fairview.direct-ci.com

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 18

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1609392695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 LITTLE JOHN LN",
            "city": "HAVELOCK",
            "state": "NC",
            "postal_code": "285329554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352104",
            "telephone_number": "952-924-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 Little John Ln",
            "address_purpose": "LOCATION",
            "city": "Havelock",
            "state": "NC",
            "postal_code": "285329554",
            "country_code": "US",
            "telephone_number": "252-675-9302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "NICHOLAS",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MN",
            "license": "5385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.