Individual provider Active NPI

Jose S Villarreal, DO

  • Hospitalist Physician
  • West Palm Beach, FL
National Provider Identifier
1619996436
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
OS10951 Issued in FL
Practice address
901 45TH Street
Suite Cl149
West Palm Beach, FL 33407-2413
Phone
(561) 882-4541
Fax
(561) 650-6093
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X OS10951 FL Primary
Family Medicine Physician 207Q00000X OS10951 FL

Addresses

Primary practice location

901 45TH Street
Suite Cl149
West Palm Beach, FL 33407-2413

Mailing address

901 45TH Street
Suite Cl149
West Palm Beach, FL 33407-2413
Phone (561) 882-4541

Other identifiers 4

IdentifierTypeStateIssuer
P00447210OtherTXRAILROAD MEDICARE PIN
008227000MedicaidFL
8X7293OtherTXBCBS
185047101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101213000286 FL Practitioner - Family Practice 4981601119 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Physician Services of Florida PAGroup PAC ID 7012201965, 212 clinicians

Practice addresses (Care Compare)

901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 882-2878

Hospital & facility affiliations

  • St Mary'S Medical Center Hospital, West Palm Beach, FL, CCN 100288

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Raulerson Primary Care LLC CurrentSince Oct 29, 2010 Accepting new patients
Hospital Physician Services of Florida PA Family Medicine CurrentSince Jun 1, 2022 Accepting new patients
Gateway Medical Group LC PastSince Oct 29, 2010 Accepting new patients

Locations

901 45th St
Ste CL149
Mangonia Park, FL 33407
Phone (561) 882-4541

202 NE 2nd St
Ste 3
Okeechobee, FL 34972
Phone (863) 467-5222

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

755 27th Ave SW
Ste 9
Vero Beach, FL 32968
Phone (772) 299-0909

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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 1

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1619996436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 45TH STREET",
            "address_2": "SUITE CL149",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-882-4541",
            "fax_number": "561-650-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 45TH STREET",
            "address_2": "SUITE CL149",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-882-4541",
            "fax_number": "561-650-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "JOSE",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS10951",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS10951",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00447210",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008227000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8X7293",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185047101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.