Individual provider Active NPI

John Frederick Villa, AGACNP

  • Acute Care Nurse Practitioner
  • Sherman Oaks, CA
National Provider Identifier
1609406990
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95033904 Issued in CA
Practice address
4929 Van Nuys Blvd
Sherman Oaks, CA 91403-1702
Phone
(661) 547-2368
NPI assigned
Jan 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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 95033904 CA Primary

Addresses

Primary practice location

4929 Van Nuys Blvd
Sherman Oaks, CA 91403-1702

Mailing address

4929 Van Nuys Blvd
Sherman Oaks, CA 91403-1702
Phone (661) 547-2368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250805000051 CA Practitioner - Nurse Practitioner 7416465059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Medical Group,IncGroup PAC ID 4385883958, 54 clinicians

Practice addresses (Care Compare)

4955 Van Nuys Blvd
Suite 308
Sherman Oaks, CA 91403-1811
Phone (818) 528-1260

Hospital & facility affiliations

  • Sherman Oaks Hospital Hospital, Sherman Oaks, CA, CCN 050755
  • Encino Hospital Medical Center Hospital, Encino, CA, CCN 050158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95033904CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
California Wound Healing Medical Group Inc. CurrentSince Jun 12, 2025 Accepting new patients
Epic Medical Group,Inc CurrentSince Jun 22, 2025 Accepting new patients
New Hope Podiatry Group Inc. PastSince Dec 29, 2024 Accepting new patients

Locations

100 E Huntington Dr
Ste 209
Alhambra, CA 91801
Phone (323) 262-4146

501 W Glenoaks Blvd
Ste 26
Glendale, CA 91202

4940 Van Nuys Blvd
Ste 200
Sherman Oaks, CA 91403
Phone (818) 528-1222

4929 Van Nuys Blvd
Van Nuys, CA 91403
Phone (818) 907-4561

4955 Van Nuys Blvd
Ste 308
Van Nuys, CA 91403
Phone (818) 387-6114

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7032/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1579910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1609406990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 VAN NUYS BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031702",
            "telephone_number": "661-547-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 VAN NUYS BLVD",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031702",
            "telephone_number": "661-547-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "JOHN",
        "middle_name": "FREDERICK",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-25",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95033904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.